Bryan Quigley, LSW – Social Worker in Stanley, ND

Key facts

NPI: 1669890398
Entity type: Individual (NPI type 1)
Primary specialty: Social Worker 104100000X
Practice address: 18 2ND Ave SE
Stanley, ND 58784-0039
Phone: (701) 628-2975
Fax: (701) 628-3175
NPI assigned: Mar 31, 2014
Sex: Male
Sole proprietor: No

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Social Worker	104100000X			Yes

Addresses

Primary practice location

18 2ND Ave SE
Stanley, ND 58784-0039

Mailing address

PO Box 39
18 2ND Ave SE
Stanley, ND 58784-0039
Phone (701) 628-2925

Other identifiers

Identifier	Type	State	Issuer
000079007	Medicaid	ND
1365	Other	ND	SW LICENSE

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 31, 2014.

{
    "created_epoch": "1396224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396224000000",
    "number": "1669890398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 39",
            "address_2": "18 2ND AVE SE",
            "city": "STANLEY",
            "state": "ND",
            "postal_code": "587840039",
            "telephone_number": "701-628-2925",
            "fax_number": "701-628-3175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 2ND AVE SE",
            "city": "STANLEY",
            "state": "ND",
            "postal_code": "587840039",
            "telephone_number": "701-628-2975",
            "fax_number": "701-628-3175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUIGLEY",
        "first_name": "BRYAN",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-31",
        "last_updated": "2014-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000079007",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SW LICENSE",
            "identifier": "1365",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stanley, ND

All providers in Stanley, ND · Social Worker in North Dakota

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 31, 2014. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.