Mid Dakota Clinic, Inc.

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

35C1001023 Issued in ND

Legal business name

MID DAKOTA CLINIC, INC.

Practice address

401 N 9TH St
Bismarck, ND 58501-4507

Phone

(701) 530-6100

Fax

(701) 530-6430

NPI assigned

Jun 12, 2006

Organization subpart

No

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

Authorized official

Name

William Heegaard

Title

President

Phone

(701) 364-4554

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666656000000",
    "number": "1366484404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 N 9TH ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585014507",
            "telephone_number": "701-530-6100",
            "fax_number": "701-530-6430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 N 9TH ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585014507",
            "telephone_number": "701-530-6100",
            "fax_number": "701-530-6430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID DAKOTA CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-12",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A",
        "authorized_official_last_name": "HEEGAARD",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "701-364-4554"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "ND",
            "license": "35C1001023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CMS",
            "identifier": "35C1001023",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00320159",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "13685",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Mickelson, MS/LAC
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• Mid Dakota Clinic, Inc.
• Midstokke Family Dentistry
• Steven J Midstokke, DDS
• Caleb J Midura, CRNA
• Midwest Vision Centers Inc (Midwest Vision Centers)

• Ambulatory Surgical Clinic/Center in Bismarck, ND
• Providers in Bismarck, ND by specialty
• Ambulatory Surgical Clinic/Center in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.