Mercy Medical Center
Organization Active NPI Psychiatry Physician · Williston, ND
NPI 1801928593 · NPPES record last updated Jun 23, 2008
Key facts
- NPI
- 1801928593
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- 5052A (ND)
- Legal business name
- MERCY MEDICAL CENTER
- Practice address
- 1301 15TH Ave W
Williston, ND 58801-3821 - Phone
- (701) 774-7401
- Fax
- (701) 774-7479
- NPI assigned
- Mar 9, 2007
- Organization subpart
- No
Authorized official
- Name
- Kerry S. Monson
- Title
- VP Finance Cfo
- Phone
- (701) 774-7401
Other NPIs on the same Medicare enrollment 8
Other NPIs with the same Medicare PAC ID 1
Practitioners 301
-
Wayne L Anderson, MD
-
Stacie Bondy, NP-C
-
Robert G. Kemp, M.D.
-
Erin Teresa Langseth, DNP
-
Amarjot Mann, MD
-
Tessa Marburger, M.D.
-
Austin James McCoy, M.D.
-
Cherise Norby, FNP
-
Heidi Nicole Oien, FNP-C
-
Bruce S. Pugatch, MD
-
Ali Syed, MD
-
Brittany K Albers, M.D.
-
Michael James Annen, M.D.
-
Norman Arslanlar, DO
-
Greg A Brown, M.D., PH.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ND
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031230000336 | ND | Part B Supplier - Clinic/Group Practice | 7416851381 |
Receives reassigned benefits from 288 practitioners 8 other NPIs on this enrollment Practice locations: Williston, ND; Tioga, ND |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist |
103T00000X | 5052A | ND | |
| Clinical Social Worker |
1041C0700X | 5052A | ND | |
| Psychiatry Physician |
2084P0800X | 5052A | ND | Yes |
Addresses
Primary practice location
1301 15TH Ave W
Williston, ND 58801-3821
Mailing address
1301 15TH Ave W
Williston, ND 58801-3821
Phone (701) 774-7401
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11684 | Medicaid | ND | |
| 711002 | Other | ND | BLUE SHIELD OF ND |
Other providers in Williston, ND
- Mercy Medical Center
- Mercy Medical Center
- Mercy Medical Center
- Mercy Medical Center
- Mercy Medical Center
- Mercy Medical Center
- Mercy Medical Center
- Mercy Medical Center, Dba Mercy Health Partners Specialty Group
- Mercy Recovery Center
- Mercy Recovery Center Residential Treatment Center
All providers in Williston, ND · Psychiatry Physician 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 Jun 23, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.