Active NPI
Jacobson Memorial Hospital Care Center
- Rural Health Clinic/Center
- Hebron, ND
National Provider Identifier
1376651463
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rural Health Clinic/Center
- Legal business name
- JACOBSON MEMORIAL HOSPITAL CARE CENTER
- Practice address
- 811 Main St
Hebron, ND 58638 - Phone
- (701) 878-4250
- Fax
- (701) 878-4346
- NPI assigned
- Aug 28, 2006
- Organization subpart
- Yes
- Parent organization
- JACOBSON MEMORIAL HOSPITAL
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- James Opdahl
- Title
- Ceo
- Phone
- (701) 584-2792
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | Primary |
Addresses
Primary practice location
811 Main St
Hebron, ND 58638
Mailing address
601 East St N
Elgin, ND 58533-7105
Phone (701) 584-2792
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 05170 | Medicaid | ND | |
| 06043001 | Other | ND | BCBS - HEBRON RHC |
Other names 1
- Hebron Community Clinic
National Provider Directory
National Provider Directory- Part of
- Jacobson Memorial Hospital
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
-
- Rural Health Clinic/Center
- Richardton, ND
- NPI 1043649486
Member Of
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156723200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1218499200000",
"number": "1376651463",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "601 EAST ST N",
"city": "ELGIN",
"state": "ND",
"postal_code": "585337105",
"telephone_number": "701-584-2792",
"fax_number": "701-584-3348"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "811 MAIN ST",
"city": "HEBRON",
"state": "ND",
"postal_code": "58638",
"telephone_number": "701-878-4250",
"fax_number": "701-878-4346"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "JACOBSON MEMORIAL HOSPITAL CARE CENTER",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "JACOBSON MEMORIAL HOSPITAL",
"enumeration_date": "2006-08-28",
"last_updated": "2008-08-12",
"status": "A",
"authorized_official_last_name": "OPDAHL",
"authorized_official_first_name": "JAMES",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "701-584-2792"
},
"taxonomies": [
{
"code": "261QR1300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Rural Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "05170",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS - HEBRON RHC",
"identifier": "06043001",
"state": "ND"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Hebron Community Clinic",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Hebron, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.