NPIMap

Organization Active NPI

Spirit Lake Tribe

Doing business as Community Health Representatives

  • Case Management Agency
  • Fort Totten, ND
National Provider Identifier
1841619798
Registry record updated Apr 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
SPIRIT LAKE TRIBE
Doing business as
Community Health Representatives
Spirit Lake Health Center
Practice address
816 3Rd Ave N
Fort Totten, ND 58335-9998
Phone
(701) 766-4236
Fax
(701) 766-4878
NPI assigned
Apr 8, 2014
Last updated
Apr 21, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2021

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

Authorized official

Name
Mrs. Donald Parisien
Title
Tribal Health Director
Phone
(701) 230-5696

Specialties & licenses 12

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X NU Primary
Health Service Clinic/Center 261QH0100X ND
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X ND
State or Local Public Health Clinic/Center 261QP0905X ND
Podiatric Clinic/Center 261QP1100X ND
Primary Care Clinic/Center 261QP2300X ND
Mammography Clinic/Center 261QR0206X ND
Clinical Medical Laboratory 291U00000X ND
Land Ambulance 3416L0300X ND
Non-emergency Medical Transport (VAN) 343900000X NU
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 332800000X ND
Case Manager/Care Coordinator 171M00000X NU

Addresses

Primary practice location

816 3Rd Ave N
Fort Totten, ND 58335-9998

Mailing address

816 3Rd Ave N
Fort Totten, ND 58335
Phone (701) 766-4236

Other practice location 1

3883 74th Avenue NE
Fort Totten, ND 58335
Phone (701) 766-1600

Other identifiers 1

IdentifierTypeStateIssuer
1466035MedicaidND

Other names 2

  • COMMUNITY HEALTH REPRESENTATIVES Doing business as
  • Spirit Lake Health Center Doing business as

Electronic endpoints 2

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

National Provider Directory

National Provider Directory
Tax ID family
Spirit Lake Senior Services22 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": "1396915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618963200000",
    "number": "1841619798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "816 3RD AVE N",
            "city": "FORT TOTTEN",
            "state": "ND",
            "postal_code": "58335",
            "telephone_number": "701-766-4236",
            "fax_number": "701-766-4878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "816 3RD AVE N",
            "city": "FORT TOTTEN",
            "state": "ND",
            "postal_code": "583359998",
            "telephone_number": "701-766-4236",
            "fax_number": "701-766-4878"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3883 74th Avenue NE",
            "address_purpose": "LOCATION",
            "city": "Fort Totten",
            "state": "ND",
            "postal_code": "58335",
            "country_code": "US",
            "telephone_number": "701-766-1600",
            "fax_number": "701-766-1630",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SPIRIT LAKE TRIBE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-08",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "status": "A",
        "authorized_official_last_name": "PARISIEN",
        "authorized_official_first_name": "DONALD",
        "authorized_official_title_or_position": "TRIBAL HEALTH DIRECTOR",
        "authorized_official_telephone_number": "701-230-5696",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "ND",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "ND",
            "license": null,
            "primary": false
        },
        {
            "code": "261QP0905X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Public Health, State or Local",
            "state": "ND",
            "license": null,
            "primary": false
        },
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": "ND",
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "ND",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0206X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mammography",
            "state": "ND",
            "license": null,
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "ND",
            "license": null,
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "ND",
            "license": null,
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "332800000X",
            "taxonomy_group": "",
            "desc": "Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy",
            "state": "ND",
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1466035",
            "state": "ND"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ftc@ftc.directihs.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3883 74th Avenue NE",
            "city": "Fort Totten",
            "state": "ND",
            "country_code": "US",
            "postal_code": "58335",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ftc@ftc.directihs.net",
            "affiliation": "N",
            "address_1": "3883 74th Avenue NE",
            "city": "Fort Totten",
            "state": "ND",
            "country_code": "US",
            "postal_code": "58335",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "COMMUNITY HEALTH REPRESENTATIVES",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Spirit Lake Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "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 Apr 21, 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.