St. Andrew's Bottineau Clinic, LLC

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

License

353851 Issued in ND

Legal business name

ST. ANDREW'S BOTTINEAU CLINIC, LLC

Practice address

314 Ohmer St
Bottineau, ND 58318-1045

Phone

(701) 228-9400

Fax

(701) 228-3245

NPI assigned

Jul 7, 2005

Last updated

Apr 30, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Jodi Atkinson

Title

Ceo/President

Phone

(701) 228-9300

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

• St. Andrew's Hospital

  dba St. Andrew's Bottineau Clinic

  • Rural Health Clinic/Center
  • Bottineau, ND
  • NPI 1295497097

  Member Of

  NPD member
• Trinity Health

  dba TCC-Western Dakota X-Ray

  • Radiology Clinic/Center
  • Williston, ND
  • NPI 1811030752

  Member Of

  NPD member

Locations

Change-of-ownership history 1

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

• St. Andrew's Hospital

  dba St. Andrew's Bottineau Clinic

  • Rural Health Clinic/Center
  • Bottineau, ND
  • NPI 1295497097

  Sold to, 2020-11-30

  CMS change of ownership

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272585600000",
    "number": "1902803802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 OHMER ST",
            "city": "BOTTINEAU",
            "state": "ND",
            "postal_code": "583181045",
            "telephone_number": "701-228-9400",
            "fax_number": "701-228-3245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 OHMER ST",
            "city": "BOTTINEAU",
            "state": "ND",
            "postal_code": "583181045",
            "telephone_number": "701-228-9400",
            "fax_number": "701-228-3245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. ANDREW'S BOTTINEAU CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-07",
        "last_updated": "2010-04-30",
        "status": "A",
        "authorized_official_last_name": "ATKINSON",
        "authorized_official_first_name": "JODI",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "701-228-9300",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "ND",
            "license": "353851",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10818",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05165",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Steven E Shank
• Maria Shingleton
• St Andrews Hospital (SMP Health - St. Andrew's)
• St Andrews Hospital (St Andrew's Health Center)
• St. Andrew's Bottineau Clinic, LLC
• St. Andrew's Hospital (SMP Health - St. Andrew's)
• St. Andrew's Hospital (St. Andrew's Bottineau Clinic)
• St. Andrew's Hospital (SMP Health - St. Andrew's)
• St. Andrew's Hospital (St. Andrew's Health Center)
• St. Andrew's Hospital (SMP Health - St. Andrew's)

• Rural Health Clinic/Center in Bottineau, ND
• Providers in Bottineau, ND by specialty
• Rural Health Clinic/Center in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.