St. James' of North Dakota, LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

License

7174 Issued in ND

Legal business name

ST. JAMES' OF NORTH DAKOTA, LLC

Practice address

1007 4TH Ave S
Wishek, ND 58495-7527

Phone

(701) 751-8008

NPI assigned

Mar 5, 2012

Organization subpart

No

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

Authorized official

Name

Emmet Michael Kenney Jr., MD

Title

President/Ceo

Phone

(701) 751-8008

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1330905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330905600000",
    "number": "1891069191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3120Z 25TH ST S # 344",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581035054",
            "telephone_number": "701-751-8008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 4TH AVE S",
            "city": "WISHEK",
            "state": "ND",
            "postal_code": "584957527",
            "telephone_number": "701-751-8008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JAMES' OF NORTH DAKOTA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-05",
        "last_updated": "2012-03-05",
        "status": "A",
        "authorized_official_last_name": "KENNEY",
        "authorized_official_first_name": "EMMET",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "701-751-8008",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "ND",
            "license": "7174",
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "ND",
            "license": "7174",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Riley Mattheis
• Angela M Parker, P.A.
• Kay Rau, PA-C
• Trina Elizabeth Schilling, FNP
• Courtney Short, FNP
• Echolyn Windy Ulmer
• Shawn T K Walker, M.D.
• Cari Ann Wiest
• Wishek Drug
• Wishek Home for the Aged

• All providers in Wishek, ND
• Adult Mental Health Clinic/Center in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2012; 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.