Hetland Ear Nose Throat PC

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

11581 Issued in ND

Legal business name

HETLAND EAR NOSE THROAT PC

Practice address

2331 Tyler Pkwy Ste 6
Bismarck, ND 58503-0871

Phone

(701) 258-6851

Fax

(701) 258-6852

NPI assigned

Nov 28, 2016

Organization subpart

No

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

Authorized official

Name

Andrew Ryan Hetland, M.D.NPI 1457302622

Title

President

Phone

(701) 934-1393

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ND

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/13015/brand/1/csg/1/fhir/r4

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Andrew R Hetland, M.D.

  • Otolaryngology Physician
  • Bismarck, ND
  • NPI 1457302622
  Medicare reassignment Care Compare group NPD Authorized official
• Mandi R Green, AUD

  • Audiologist
  • Grand Forks, ND
  • NPI 1770702060
  Medicare reassignment Care Compare group NPD
• Jacquelyn A Liffrig, RN, BSN, FNP-C

  • Family Nurse Practitioner
  • Garrison, ND
  • NPI 1407238371
  Medicare reassignment Care Compare group NPD
• Brian Torske, FNP

  • Family Nurse Practitioner
  • Bismarck, ND
  • NPI 1558591131
  Medicare reassignment Care Compare group NPD
• Paige Voltz, FNP

  • Family Nurse Practitioner
  • Bismarck, ND
  • NPI 1619585981
  Medicare reassignment Care Compare group NPD
• Nicholas Christ, CRNA

  • Certified Registered Nurse Anesthetist
  • Bismarck, ND
  • NPI 1932597770
  NPD (past)

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

{
    "created_epoch": "1480291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1932642790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2331 TYLER PKWY STE 6",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585030871",
            "telephone_number": "701-258-6851",
            "fax_number": "701-258-6852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2331 TYLER PKWY STE 6",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585030871",
            "telephone_number": "701-258-6851",
            "fax_number": "701-258-6852"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "810 E Rosser Ave",
            "address_2": "Suite 310",
            "address_purpose": "LOCATION",
            "city": "Bismarck",
            "state": "ND",
            "postal_code": "585014463",
            "country_code": "US",
            "telephone_number": "701-934-1393",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HETLAND EAR NOSE THROAT PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-28",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "HETLAND",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "RYAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "701-934-1393",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "ND",
            "license": "11581",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NPI",
            "identifier": "1457302622",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dwight J Hertz, MD
• Troy Vernon Hertz, PHARMD
• William Hertz, FNP-C
• Susan Kay Herzog, LICSW
• Kevin A Hessinger, CRNA
• Andrew R Hetland, M.D.
• Bruce M Hetland, MD
• Madison Jae Hetletved, APRN, CNP
• Kodi Lynn Hettich, MS, LAPC
• Amanda R Heupel

• Otolaryngology Physician in Bismarck, ND
• Providers in Bismarck, ND by specialty
• Otolaryngology Physician in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.