Living Well Dakota

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

LIVING WELL DAKOTA

Practice address

1140 W Capitol Ave
Bismarck, ND 58501-1306

Phone

(701) 989-8251

NPI assigned

Sep 15, 2021

Organization subpart

No

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

Authorized official

Name

Jody Tanner, PA-CNPI 1215942057

Title

Provider

Phone

(701) 989-8251

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 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jody Saltern Tanner, PA

  • Physician Assistant
  • Jamestown, ND
  • NPI 1215942057
  NPD Authorized official

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

{
    "created_epoch": "1631664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631664000000",
    "number": "1619647211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6612 DAKOTA COUNTRY DR",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585031550",
            "telephone_number": "701-989-8251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 W CAPITOL AVE",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585011306",
            "telephone_number": "701-989-8251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVING WELL DAKOTA",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-15",
        "last_updated": "2021-09-15",
        "certification_date": "2021-09-15",
        "status": "A",
        "authorized_official_last_name": "TANNER",
        "authorized_official_first_name": "JODY",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "701-989-8251",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kirsten Little, M.S.
• Stephanie Little, LCSW
• William Gregory Littlefield, LAT, ATC
• Lisa M Livesay, MS, OTR/L
• Travis William Livesay, D.C.
• LJS Enterprises LLC
• Lim-Che Lo, MD
• Hannah Rose Lockrem
• Tracey M.E. Lockrem, M.S., CCC/SLP
• Chantale Logan

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2021; 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.