NPIMap

Organization Active NPI

Bois Forte Reservation Tribal Government

Doing business as Bois Forte Medical Clinic Pharmacy

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Nett Lake, MN
National Provider Identifier
1972666469
Registry record updated Feb 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Indian Health Service/Tribal/Urban Indian Health (I/T/U) PharmacyTaxonomy code 332800000X
Legal business name
BOIS FORTE RESERVATION TRIBAL GOVERNMENT
Doing business as
Bois Forte Medical Clinic Pharmacy
Practice address
5219 St John Dr
Nett Lake, MN 55772
Phone
(218) 757-3650
Fax
(218) 757-0234
NPI assigned
Dec 18, 2006
Last updated
Feb 25, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
BOIS FORTE RESERVATION TRIBAL GOVERNMENTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 25, 2026

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

Authorized official

Name
Christie Swanson
Title
PRC and Billing Specialist
Phone
(218) 757-3650

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X 261489-2 MN
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 332800000X NU Primary

Addresses

Primary practice location

5219 St John Dr
Nett Lake, MN 55772

Mailing address

5219 Saint John Dr
Orr, MN 55771-8232
Phone (218) 757-3650

Other identifiers 3

IdentifierTypeStateIssuer
0104492OtherMNMEDICA
177515400MedicaidMN
63G35BOOtherMNBCBS

Other names 1

  • Bois Forte Medical Clinic Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031105000284 MN Part B Supplier - Clinic/Group Practice 7517879778 Receives reassigned benefits from 9 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Orr, MN; Tower, MN
O20250122003077 MN DME Supplier - Pharmacy 7517879778 Practice locations: Orr, MN

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Bois Forte Reservation Tribal Council9 organizations share this tax ID, including this one
Part of
Bois Forte Reservation Tribal Council

Other organizations with this tax ID 8

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

Locations

13071 Nett Lake Rd
#A
Orr, MN 55771
Phone (218) 757-3650

13071 Nett Lake Rd
#B
Orr, MN 55771
Phone (218) 757-3650

13090 Westley Rd
Ste B
Orr, MN 55771

1610 Farm Rd S
Tower, MN 55790
Phone (218) 753-2182

1610 Farm Rd S
Ste B
Tower, MN 55790
Phone (218) 753-2037

Practitioners & affiliated clinicians

Practitioners 8

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": "1166400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771977600000",
    "number": "1972666469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5219 SAINT JOHN DR",
            "city": "ORR",
            "state": "MN",
            "postal_code": "557718232",
            "telephone_number": "218-757-3650",
            "fax_number": "218-757-0234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5219 ST JOHN DR",
            "city": "NETT LAKE",
            "state": "MN",
            "postal_code": "55772",
            "telephone_number": "218-757-3650",
            "fax_number": "218-757-0234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOIS FORTE RESERVATION TRIBAL GOVERNMENT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BOIS FORTE RESERVATION TRIBAL GOVERNMENT",
        "enumeration_date": "2006-12-18",
        "last_updated": "2026-02-25",
        "certification_date": "2026-02-25",
        "status": "A",
        "authorized_official_last_name": "SWANSON",
        "authorized_official_first_name": "CHRISTIE",
        "authorized_official_title_or_position": "PRC AND BILLING SPECIALIST",
        "authorized_official_telephone_number": "218-757-3650"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "MN",
            "license": "261489-2",
            "primary": false
        },
        {
            "code": "332800000X",
            "taxonomy_group": "",
            "desc": "Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "0104492",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "177515400",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "63G35BO",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bois Forte Medical Clinic Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bois Forte Medical Clinic Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Nett Lake, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2026; 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.