Organization Active NPI

4TH Corporaiton

  • Intellectual Disabilities Intermediate Care Facility
  • New Rockford, ND
National Provider Identifier
1740347764
Registry record updated Feb 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Legal business name
4TH CORPORAITON
Practice address
120 11TH St N
New Rockford, ND 58356-1434
Phone
(701) 947-2147
NPI assigned
Jan 2, 2007
Last updated
Feb 15, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2008

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

Authorized official

Name
Kodi Keller
Title
Business Manager
Phone
(701) 947-2147

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X ND Primary

Addresses

Primary practice location

120 11TH St N
New Rockford, ND 58356-1434

Mailing address

120 11TH St N
New Rockford, ND 58356-1434
Phone (701) 947-2147

National Provider Directory

National Provider Directory
Tax ID family
4TH Corporaiton5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203033600000",
    "number": "1740347764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 11TH ST N",
            "city": "NEW ROCKFORD",
            "state": "ND",
            "postal_code": "583561434",
            "telephone_number": "701-947-2147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 11TH ST N",
            "city": "NEW ROCKFORD",
            "state": "ND",
            "postal_code": "583561434",
            "telephone_number": "701-947-2147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "4TH CORPORAITON",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-02",
        "last_updated": "2008-02-15",
        "status": "A",
        "authorized_official_last_name": "KELLER",
        "authorized_official_first_name": "KODI",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "701-947-2147"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "ND",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Rockford, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2008; 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.