NPIMap

Organization Active NPI

Peace Garden Multi-District Cooperative

Doing business as Peace Garden Special Services

  • Local Education Agency (LEA)
  • Bottineau, ND
National Provider Identifier
1467501627
Registry record updated Jul 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Local Education Agency (LEA)Taxonomy code 251300000X
Legal business name
PEACE GARDEN MULTI-DISTRICT COOPERATIVE
Doing business as
Peace Garden Special Services
Practice address
309 2ND St E
Bottineau, ND 58318-1104
Phone
(701) 228-3743
Fax
(701) 228-3365
NPI assigned
Jan 9, 2007
Last updated
Jul 16, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2024

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

Authorized official

Name
Ms. Melissa DeckertNPI 1629815402
Title
Director
Phone
(701) 228-3743

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 19019 ND
Occupational Therapist 225X00000X 19019 ND
Speech-Language Pathologist 235Z00000X 19019 ND
Local Education Agency (LEA) 251300000X NU Primary

Addresses

Primary practice location

309 2ND St E
Bottineau, ND 58318-1104

Mailing address

309 2ND St E
Bottineau, ND 58318-1104
Phone (701) 228-3743

Other identifiers 1

IdentifierTypeStateIssuer
19019MedicaidND

Other names 1

  • Peace Garden Special Services Doing business as

National Provider Directory

National Provider Directory

Locations

309 2nd St E
Bottineau, ND 58318
Phone (701) 228-3743

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721088000000",
    "number": "1467501627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 2ND ST E",
            "city": "BOTTINEAU",
            "state": "ND",
            "postal_code": "583181104",
            "telephone_number": "701-228-3743",
            "fax_number": "701-228-3365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 2ND ST E",
            "city": "BOTTINEAU",
            "state": "ND",
            "postal_code": "583181104",
            "telephone_number": "701-228-3743",
            "fax_number": "701-228-3365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACE GARDEN MULTI-DISTRICT COOPERATIVE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-09",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A",
        "authorized_official_last_name": "DECKERT",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "701-228-3743",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ND",
            "license": "19019",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "ND",
            "license": "19019",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ND",
            "license": "19019",
            "primary": false
        },
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "19019",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Peace Garden Special Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bottineau, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2024; 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.