NPIMap

Organization Active NPI

Northland Health Centers

  • Federally Qualified Health Center (FQHC)
  • Rolette, ND
National Provider Identifier
1689758039
Registry record updated Apr 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
NORTHLAND HEALTH CENTERS
Doing business as
Northland Health Centers
Practice address
401 2ND Ave
Rolette, ND 58366
Phone
(701) 246-3391
Fax
(701) 246-3422
NPI assigned
Oct 24, 2006
Last updated
Apr 17, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2026

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

Authorized official

Name
Rachel Thomas
Title
Cfo
Phone
(701) 707-2269

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

401 2ND Ave
Rolette, ND 58366

Mailing address

PO Box 535
Turtle Lake, ND 58575-0535
Phone (701) 448-2054

Other names 1

  • Northland Health Centers Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20030513000017 ND Part A Provider - Federally Qualified Health Center (FQHC) 1557270113 Practice locations: Rolette, ND
O20031106000411 ND Part B Supplier - Clinic/Group Practice 1557270113 Receives reassigned benefits from 22 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Rolette, ND; Turtle Lake, ND; Saint John, ND; Ray, ND; Minot, ND; McClusky, ND; Bowbells, ND; Bismarck, ND

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1689758039. Details of each certification follow.

Federally qualified health center certification: CCN 351805

Legal name
NORTHLAND HEALTH PARTNERS COMMUNITY HEALTH CENTER
Doing business as
NORTHLAND HEALTH CENTERS
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 1, 2003
Last certification
Mar 1, 2003
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Nov 13, 2002 in ND
Enrollment address
401 2ND Ave
Rolette, ND 58366-7029

Other NPIs with the same Medicare PAC ID 9

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
35D0408691Northland Community Health Center - Rolette401 2ND Ave, Rolette, ND 58366Certificate of waiverFeb 29, 2028

National Provider Directory

National Provider Directory
Tax ID family
Northland HLTH Prtnr Co8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Walter Lipp Individual Corporate Director Jan 23, 2012
Nadine Boe Individual Corporate OfficerCeo Dec 1, 2018 5%
W-2 Managing EmployeeCeo Dec 1, 2018 5%
Rachel Thomas Individual Corporate OfficerCfo Jan 1, 2019 5%
W-2 Managing EmployeeCfo Jan 1, 2019 5%

Practitioners & affiliated clinicians

Practitioners 8

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": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776384000000",
    "number": "1689758039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 535",
            "city": "TURTLE LAKE",
            "state": "ND",
            "postal_code": "585750535",
            "telephone_number": "701-448-2054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 2ND AVE",
            "city": "ROLETTE",
            "state": "ND",
            "postal_code": "58366",
            "telephone_number": "701-246-3391",
            "fax_number": "701-246-3422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHLAND HEALTH CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-24",
        "last_updated": "2026-04-17",
        "certification_date": "2026-04-17",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "701-707-2269"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northland Health Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rolette, ND

Sources for this page

Verify at the official NPI Registry.