NPIMap

Organization Active NPI

Spectra Health

  • Federally Qualified Health Center (FQHC)
  • Grand Forks, ND
National Provider Identifier
1841953379
Registry record updated Oct 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
SPECTRA HEALTH
Practice address
212 S 4TH St Ste 301
Grand Forks, ND 58201-4776
Phone
(701) 757-2100
NPI assigned
Oct 21, 2021
Last updated
Oct 21, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2021

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

Authorized official

Name
Tiffany Schmidt
Title
Cfo
Phone
(701) 757-2100

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Chiropractor 111N00000X

Addresses

Primary practice location

212 S 4TH St Ste 301
Grand Forks, ND 58201-4776

Mailing address

212 S 4TH St
Grand Forks, ND 58201-4777
Phone (701) 757-2100

Other identifiers 1

IdentifierTypeStateIssuer
1461598MedicaidND

Other names 1

  • Valley Community Health Centers Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Valley Community HLTH CTRS4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

212 S 4th St
Grand Forks, ND 58201
Phone (701) 757-2100

Practitioners & affiliated clinicians

Practitioners 6

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": "1634774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634774400000",
    "number": "1841953379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 S 4TH ST",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582014777",
            "telephone_number": "701-757-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 S 4TH ST STE 301",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582014776",
            "telephone_number": "701-757-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTRA HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-21",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-04",
        "status": "A",
        "authorized_official_last_name": "SCHMIDT",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "701-757-2100"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1461598",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Valley Community Health Centers",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Grand Forks, ND

Sources for this page

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