Organization Active NPI

North Star Family Clinic PLLC

Doing business as North Star Family Clinic

  • Family Nurse Practitioner
  • Williston, ND
National Provider Identifier
1821769159
Registry record updated Dec 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
NORTH STAR FAMILY CLINIC PLLC
Doing business as
North Star Family Clinic
Practice address
1500 14TH St W Ste 230
Williston, ND 58801-4078
Phone
(701) 774-0390
Fax
(701) 774-0391
NPI assigned
Sep 27, 2021
Last updated
Dec 6, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2021

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

Authorized official

Name
Brandy Shahin, FNP-C
Title
Owner
Phone
(701) 774-0390

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

1500 14TH St W Ste 230
Williston, ND 58801-4078

Mailing address

3620 6TH Ave E
Williston, ND 58801-6360
Phone (701) 774-0390

Other names 1

  • North Star Family Clinic Doing business as

National Provider Directory

National Provider Directory

Locations

1500 14th St W
Ste 230
Williston, ND 58801
Phone (701) 572-3335

1500 14th St W
Ste 270
Williston, ND 58801

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1632700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638748800000",
    "number": "1821769159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3620 6TH AVE E",
            "city": "WILLISTON",
            "state": "ND",
            "postal_code": "588016360",
            "telephone_number": "701-774-0390",
            "fax_number": "701-774-0391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 14TH ST W STE 230",
            "city": "WILLISTON",
            "state": "ND",
            "postal_code": "588014078",
            "telephone_number": "701-774-0390",
            "fax_number": "701-774-0391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH STAR FAMILY CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-27",
        "last_updated": "2021-12-06",
        "certification_date": "2021-12-06",
        "status": "A",
        "authorized_official_last_name": "SHAHIN",
        "authorized_official_first_name": "BRANDY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "701-774-0390",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Star Family Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "North Star Family Clinic",
            "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 Dec 6, 2021; 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.