NPIMap

Organization Active NPI

Spirit Lake Tribe

  • Non-emergency Medical Transport (VAN)
  • Fort Totten, ND
National Provider Identifier
1821622010
Registry record updated Feb 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-emergency Medical Transport (VAN)Taxonomy code 343900000X
Legal business name
SPIRIT LAKE TRIBE
Practice address
3883 74TH Ave NE
Fort Totten, ND 58335-0309
Phone
(701) 766-1600
Fax
(701) 766-1630
NPI assigned
Feb 26, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2020

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

Authorized official

Name
Arlene Krulish
Title
Ceo
Phone
(701) 766-1607

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-emergency Medical Transport (VAN) 343900000X Primary

Addresses

Primary practice location

3883 74TH Ave NE
Fort Totten, ND 58335-0309

Mailing address

PO Box 309
Fort Totten, ND 58335-0309
Phone (701) 766-1600

Other identifiers 1

IdentifierTypeStateIssuer
1470084MedicaidND

Other names 1

  • Spirit Lake Health Center Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ftc@ftc.directihs.net Direct

National Provider Directory

National Provider Directory
Tax ID family
Spirit Lake Okiciyapi22 organizations share this tax ID, including this one

Other organizations with this tax ID 21

Organizations that report the same tax identification number in the National Provider Directory.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1582675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582675200000",
    "number": "1821622010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 309",
            "city": "FORT TOTTEN",
            "state": "ND",
            "postal_code": "583350309",
            "telephone_number": "701-766-1600",
            "fax_number": "701-766-1630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3883 74TH AVE NE",
            "city": "FORT TOTTEN",
            "state": "ND",
            "postal_code": "583350309",
            "telephone_number": "701-766-1600",
            "fax_number": "701-766-1630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPIRIT LAKE TRIBE",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-26",
        "last_updated": "2020-02-26",
        "certification_date": "2020-02-26",
        "status": "A",
        "authorized_official_last_name": "KRULISH",
        "authorized_official_first_name": "ARLENE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "701-766-1607"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1470084",
            "state": "ND"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ftc@ftc.directihs.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3883 74th Ave NE",
            "city": "Fort Totten",
            "state": "ND",
            "country_code": "US",
            "postal_code": "583350309",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Spirit Lake Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Totten, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2020; 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.