NPIMap

Organization Active NPI

White Earth Band of Chippewa

  • Podiatric Clinic/Center
  • White Earth, MN
National Provider Identifier
1851301378
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Podiatric Clinic/CenterTaxonomy code 261QP1100X
Legal business name
WHITE EARTH BAND OF CHIPPEWA
Practice address
26246 Crane Rd
White Earth, MN 56591-9998
Phone
(218) 983-3285
Fax
(218) 983-4299
NPI assigned
Aug 8, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Monte Fox, EP
Title
Diabetes Project Manager
Phone
(218) 983-3285

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatric Clinic/Center 261QP1100X MN Primary

Addresses

Primary practice location

26246 Crane Rd
White Earth, MN 56591-9998

Mailing address

PO Box 418
White Earth, MN 56591-0418
Phone (218) 983-3285

Other identifiers 1

IdentifierTypeStateIssuer
464M3WHOtherMNBCBS OF MN & CCS TPA

Other names 1

  • White Earth Diabetes Project Other name

National Provider Directory

National Provider Directory
Tax ID family
White Earth Oshki Manidoo New Spirit Center26 organizations share this tax ID, including this one

Other organizations with this tax ID 25

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

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1851301378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 418",
            "city": "WHITE EARTH",
            "state": "MN",
            "postal_code": "565910418",
            "telephone_number": "218-983-3285",
            "fax_number": "218-983-4299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26246 CRANE RD",
            "city": "WHITE EARTH",
            "state": "MN",
            "postal_code": "565919998",
            "telephone_number": "218-983-3285",
            "fax_number": "218-983-4299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITE EARTH BAND OF CHIPPEWA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FOX",
        "authorized_official_first_name": "MONTE",
        "authorized_official_title_or_position": "DIABETES PROJECT MANAGER",
        "authorized_official_telephone_number": "218-983-3285",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "EP"
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MN & CCS TPA",
            "identifier": "464M3WH",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "White Earth Diabetes Project",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in White Earth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.