Organization Active NPI

Eldercare of Bemidji, Inc

  • Assisted Living Facility
  • Bemidji, MN
National Provider Identifier
1356969869
Registry record updated Jun 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
ELDERCARE OF BEMIDJI, INC
Practice address
1511 Delton Ave NW
Bemidji, MN 56601-2586
Phone
(218) 444-4999
Fax
(218) 444-5603
NPI assigned
Jul 10, 2020
Organization subpart
Yes
Parent organization
ELDERCARE OF BEMIDJI, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 6, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Barbara Ann Caspers
Title
Finance Director
Phone
(218) 766-1154

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

1511 Delton Ave NW
Bemidji, MN 56601-2586

Mailing address

1511 Delton Ave NW
Bemidji, MN 56601-2586
Phone (218) 444-4999

Other identifiers 1

IdentifierTypeStateIssuer
A667908200MedicaidMN

Other names 1

  • Tamarack Court Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
24D2098929Tamarack Court1511 Delton Ave NW, Bemidji, MN 56601Certificate of waiverJul 16, 2027

National Provider Directory

National Provider Directory
Tax ID family
Eldercare of Bemidji Inc3 organizations share this tax ID, including this one
Part of
Eldercare of Bemidji Inc

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1594339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686009600000",
    "number": "1356969869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1511 DELTON AVE NW",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566012586",
            "telephone_number": "218-444-4999",
            "fax_number": "218-444-5603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1511 DELTON AVE NW",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566012586",
            "telephone_number": "218-444-4999",
            "fax_number": "218-444-5603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELDERCARE OF BEMIDJI, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ELDERCARE OF BEMIDJI, INC",
        "enumeration_date": "2020-07-10",
        "last_updated": "2023-06-06",
        "certification_date": "2023-06-06",
        "status": "A",
        "authorized_official_last_name": "CASPERS",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "FINANCE DIRECTOR",
        "authorized_official_telephone_number": "218-766-1154"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "A667908200",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tamarack Court",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Tamarack Court",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bemidji, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.