NPIMap

Organization Active NPI

Naytahwaush Health Center

Doing business as White Earth Health Center

  • Federal Public Health Clinic/Center
  • Mahnomen, MN
National Provider Identifier
1740202308
Registry record updated Oct 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federal Public Health Clinic/CenterTaxonomy code 261QP0904X
Legal business name
NAYTAHWAUSH HEALTH CENTER
Doing business as
White Earth Health Center
Practice address
2471 310TH Ave
Mahnomen, MN 56557-9393
Phone
(218) 935-2238
Fax
(218) 935-5085
NPI assigned
Jul 24, 2006
Last updated
Oct 9, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
WHITE EARTH INDIAN HEALTH CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 9, 2025

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

Authorized official

Name
Jocelyn Jackson
Title
Administrative Officer
Phone
(218) 983-4300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federal Public Health Clinic/Center 261QP0904X NU Primary

Addresses

Primary practice location

2471 310TH Ave
Mahnomen, MN 56557-9393

Mailing address

2471 310TH Ave
Mahnomen, MN 56557-9393
Phone (218) 935-2238

Other names 2

  • White Earth Health Center Doing business as
  • Waabanookwe Health Center Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040422000363 TX Part B Supplier - Clinic/Group Practice 1658367925 Receives reassigned benefits from 52 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Ponsford, MN; Ogema, MN; Mahnomen, MN

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory
Part of
White Earth Indian Health Center

Locations

2471 310th Ave
Mahnomen, MN 56557
Phone (218) 935-2238

2471 310th Ave
#C
Mahnomen, MN 56557
Phone (218) 935-2238

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 71

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.

View all 71

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759968000000",
    "number": "1740202308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2471 310TH AVE",
            "city": "MAHNOMEN",
            "state": "MN",
            "postal_code": "565579393",
            "telephone_number": "218-935-2238",
            "fax_number": "218-935-5085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2471 310TH AVE",
            "city": "MAHNOMEN",
            "state": "MN",
            "postal_code": "565579393",
            "telephone_number": "218-935-2238",
            "fax_number": "218-935-5085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NAYTAHWAUSH HEALTH CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WHITE EARTH INDIAN HEALTH CENTER",
        "enumeration_date": "2006-07-24",
        "last_updated": "2025-10-09",
        "certification_date": "2025-10-09",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "JOCELYN",
        "authorized_official_title_or_position": "ADMINISTRATIVE OFFICER",
        "authorized_official_telephone_number": "218-983-4300"
    },
    "taxonomies": [
        {
            "code": "261QP0904X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Public Health, Federal",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "White Earth Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "White Earth Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Waabanookwe Health Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Mahnomen, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.