Organization Active NPI

John B Andelin MD PC

  • Anatomic Pathology & Clinical Pathology Physician
  • Williston, ND
National Provider Identifier
1821248477
Registry record updated Sep 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
5162 Issued in ND
Legal business name
JOHN B ANDELIN MD PC
Practice address
1301 15TH Ave W
Williston, ND 58801-3821
Phone
(701) 572-3800
Fax
(701) 774-7402
NPI assigned
Sep 19, 2008
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Dr. John B Andelin, MD
Title
Owner
Phone
(701) 572-3800

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

National Provider Directory

Locations

216 2ND Ave SW
Sidney, MT 59270
Phone (701) 572-3800

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ZP0102X 5162 ND Primary

Addresses

NPPES NPI Registry

Primary practice location

1301 15TH Ave W
Williston, ND 58801-3821

Mailing address

201 2ND Ave W
Williston, ND 58801-5920
Phone (701) 572-3800

Other identifiers 2

NPPES NPI Registry
IdentifierTypeStateIssuer
APPLIED FORMedicaidMT
APPLIED FORMedicaidND

Other names 1

NPPES NPI Registry
  • PATHOLOGY SERVICES Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 19, 2008.

{
    "created_epoch": "1221782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221782400000",
    "number": "1821248477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 2ND AVE W",
            "city": "WILLISTON",
            "state": "ND",
            "postal_code": "588015920",
            "telephone_number": "701-572-3800",
            "fax_number": "701-774-7402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 15TH AVE W",
            "city": "WILLISTON",
            "state": "ND",
            "postal_code": "588013821",
            "telephone_number": "701-572-3800",
            "fax_number": "701-774-7402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN B ANDELIN MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-19",
        "last_updated": "2008-09-19",
        "status": "A",
        "authorized_official_last_name": "ANDELIN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "701-572-3800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "ND",
            "license": "5162",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "APPLIED FOR",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "APPLIED FOR",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PATHOLOGY SERVICES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Williston, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 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.