Elbowoods Memorial Health Center
Organization Active NPI Clinic/Center · New Town, ND
NPI 1831365519 · NPPES record last updated Nov 18, 2024
Key facts
- NPI
- 1831365519
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinic/Center 261Q00000X
- Legal business name
- ELBOWOODS MEMORIAL HEALTH CENTER
- Practice address
- 1251 Elbowoods Loop
New Town, ND 58763 - Phone
- (701) 627-4750
- Fax
- (701) 627-2809
- NPI assigned
- May 2, 2008
- Organization subpart
- No
Authorized official
- Name
- Kathryn Eagle
- Title
- Chief Executive Officer
- Phone
- (701) 627-4750
Subparts reporting this organization as parent 12
Corporate family (same tax ID) 13
Practitioners 73
-
Bernice Annelle Dubois, DNP, APRN
-
Izuchukwu McIver Emejulu, PMHNP-BC
-
David Eugene Emmons, APRN-FNP
-
Justin Hart, LRD
-
Lexyn J Henderson, DPT
-
Lori A Jepson, NP
-
James L Jeske, O.D.
-
Ravindra P Joshi, M.D.
-
Joann K Lee, MD
-
Inna Malostovker, MD
-
Anita Louise Martin, M.D.
-
Zane C Rising Sun, M.D.
-
Guy K Slann, D.P.M.
-
Jamie Thongphet, FNP-BC
-
Tracy Beth Tomjack, D.O.
-
Samir M Turk, MD
-
Sandra Figueroa, M.D.
-
Michael Abou Jones, M.D.
-
John Perez, OD
-
Celeste Hart, RD
-
Andrea Weisz, FNP-C
-
Barry Joseph Amos, D.O.
-
Tammie M Braaflat, FNP
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 35D0409250 | Elbowoods Memorial Health Center | Compliance | Sep 20, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ND
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090310000122 | ND | Part B Supplier - Clinic/Group Practice | 1052477494 |
Receives reassigned benefits from 49 practitioners Practice locations: New Town, ND |
National Provider Directory
- Tax ID family
- Elbowoods Memorial Health Center
Locations
1251 Elbowoods Loop
New Town, ND 58763
Phone (701) 627-4750
2 Central Main St
Roseglen, ND 58775
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Management Agency | 251B00000X | |||
| Community/Behavioral Health Agency | 251S00000X | |||
| Clinic/Center | 261Q00000X | Yes | ||
| Health Service Clinic/Center | 261QH0100X | |||
| Federal Public Health Clinic/Center | 261QP0904X |
Addresses
Primary practice location
1251 Elbowoods Loop
New Town, ND 58763
Mailing address
1251 Elbowoods Loop
New Town, ND 58763
Phone (701) 627-4750
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1463340 | Medicaid | ND |
Other names
- Minne Tohe Health Center
Other providers in New Town, ND
- Elbowoods Memorial Health Center
- Elbowoods Memorial Health Center
- Elbowoods Memorial Health Center
- Elbowoods Memorial Health Center
- Elbowoods Memorial Health Center
- Elbowoods Memorial Health Center
- Elbowoods Memorial Health Center
- Elbowoods Memorial Health Center
- Elbowoods Memorial Health Center Pharmacy
- Elbwoods Memorial Health Center
All providers in New Town, ND · Clinic/Center 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 Nov 18, 2024. 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.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.