Polk-Norman-Mahnomen Community Health Board

Primary specialty

Public Health or Welfare AgencyTaxonomy code 251K00000X

Legal business name

POLK-NORMAN-MAHNOMEN COMMUNITY HEALTH BOARD

Practice address

816 Marin Ave Ste 125
Crookston, MN 56716-2148

Phone

(218) 281-3385

Fax

(218) 281-7376

NPI assigned

Nov 15, 2012

Last updated

Apr 24, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Sarah Keller-Reese, MS, CHES

Title

Lead Agent

Phone

(218) 281-3385

Specialties & licenses 1

Addresses

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

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Melissa Jeannette Hayes, FNP-C

  • Nurse Practitioner
  • Grand Forks, ND
  • NPI 1902281439
  NPD (past)
• Jami L. Mathews, FNP-C

  • Family Nurse Practitioner
  • Grand Forks, ND
  • NPI 1912510173
  NPD (past)

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

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587686400000",
    "number": "1427392455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "816 MARIN AVE STE 125",
            "city": "CROOKSTON",
            "state": "MN",
            "postal_code": "567162148",
            "telephone_number": "218-281-3385",
            "fax_number": "218-281-7376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "816 MARIN AVE STE 125",
            "city": "CROOKSTON",
            "state": "MN",
            "postal_code": "567162148",
            "telephone_number": "218-281-3385",
            "fax_number": "218-281-7376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POLK-NORMAN-MAHNOMEN COMMUNITY HEALTH BOARD",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-15",
        "last_updated": "2020-04-24",
        "certification_date": "2020-04-24",
        "status": "A",
        "authorized_official_last_name": "KELLER-REESE",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "LEAD AGENT",
        "authorized_official_telephone_number": "218-281-3385",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MS, CHES"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amber Marie Peterson
• David C Peterson, DPM
• Stephanie Kaitlyn Philyaw
• Polk County Auditor (Polk County Public Health)
• Polk County Social Services
• Prairie Psychological Services PA
• Breanna J. Privratsky, PA-C
• Nicole Qual, D.C.
• Norma Lynette Quam
• Jacqueline Kay Ramsey

• Public Health or Welfare Agency in Crookston, MN
• Providers in Crookston, MN by specialty
• Public Health or Welfare Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2020; 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.