Pride Wilton Inc.

Primary specialty

Nursing Care AgencyTaxonomy code 251J00000X

Legal business name

PRIDE WILTON INC.

Practice address

1200 Missouri Ave
Bismarck, ND 58504-5264

Phone

(701) 258-7838

Fax

(701) 258-3735

NPI assigned

Aug 31, 2006

Last updated

Jul 1, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Darla Roggenbuck

Title

Financial Coordinator

Phone

(701) 258-7838

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404172800000",
    "number": "1740391853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 MISSOURI AVE",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585045264",
            "telephone_number": "701-258-7838",
            "fax_number": "701-258-3735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 MISSOURI AVE",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585045264",
            "telephone_number": "701-258-7838",
            "fax_number": "701-258-3735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIDE WILTON INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2014-07-01",
        "status": "A",
        "authorized_official_last_name": "ROGGENBUCK",
        "authorized_official_first_name": "DARLA",
        "authorized_official_title_or_position": "FINANCIAL COORDINATOR",
        "authorized_official_telephone_number": "701-258-7838"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30748",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Nursing Care Agency in Bismarck, ND
• Providers in Bismarck, ND by specialty
• Nursing Care Agency in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2014; 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.