NPIMap

Organization Active NPI

Three Affiliated Tribes Dialysis Unit

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • New Town, ND
National Provider Identifier
1487728630
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
1083625354 Issued in ND
Legal business name
THREE AFFILIATED TRIBES DIALYSIS UNIT
Practice address
9281 Highway 23
New Town, ND 58763-9407
Phone
(701) 627-4840
NPI assigned
Nov 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Stella Berquist
Title
Administrator
Phone
(701) 627-4840

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X 1083625354 ND Primary

Addresses

Primary practice location

9281 Highway 23
New Town, ND 58763-9407

Mailing address

9281 Highway 23
New Town, ND 58763-9407
Phone (701) 627-4840

Other identifiers 1

IdentifierTypeStateIssuer
003123MedicaidND

National Provider Directory

National Provider Directory
Tax ID family
Three Affiliated Tribes Dialysis Unit6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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": "1163980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1487728630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9281 HIGHWAY 23",
            "city": "NEW TOWN",
            "state": "ND",
            "postal_code": "587639407",
            "telephone_number": "701-627-4840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9281 HIGHWAY 23",
            "city": "NEW TOWN",
            "state": "ND",
            "postal_code": "587639407",
            "telephone_number": "701-627-4840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THREE AFFILIATED TRIBES DIALYSIS UNIT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BERQUIST",
        "authorized_official_first_name": "STELLA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "701-627-4840"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "ND",
            "license": "1083625354",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003123",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Town, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.