Organization Active NPI

Pyramid Health, LLC

  • Clinic/Center
  • Bottineau, ND
National Provider Identifier
1992269161
Registry record updated May 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
PYRAMID HEALTH, LLC
Practice address
516 Main St
Bottineau, ND 58318-1203
Phone
(701) 534-0109
Fax
(866) 640-0723
NPI assigned
Jan 22, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2026

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

Authorized official

Name
Amy Koivula, RN
Title
Office Manager
Phone
(701) 534-0109

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

516 Main St
Bottineau, ND 58318-1203

Mailing address

PO Box 419
Bottineau, ND 58318-0401

Other identifiers 1

IdentifierTypeStateIssuer
1477108MedicaidND

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mark.koivula.1@19007.direct.athenahealth.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190517000381 ND Part B Supplier - Clinic/Group Practice 0941543797 Receives reassigned benefits from 2 practitioners
Practice locations: Bottineau, ND

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
35D2162346Pyramid Health, LLC516 Main St, Bottineau, ND 58318Certificate of waiverFeb 19, 2027

National Provider Directory

National Provider Directory

Interoperability endpoints

  • Direct secure messaging: mark.koivula.1@19007.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/19007/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1548115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779926400000",
    "number": "1992269161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 419",
            "city": "BOTTINEAU",
            "state": "ND",
            "postal_code": "583180401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 MAIN ST",
            "city": "BOTTINEAU",
            "state": "ND",
            "postal_code": "583181203",
            "telephone_number": "701-534-0109",
            "fax_number": "866-640-0723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PYRAMID HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-22",
        "last_updated": "2026-05-28",
        "certification_date": "2026-05-28",
        "status": "A",
        "authorized_official_last_name": "KOIVULA",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "701-534-0109",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1477108",
            "state": "ND"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mark.koivula.1@19007.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "516 Main St",
            "city": "Bottineau",
            "state": "ND",
            "country_code": "US",
            "postal_code": "583181203",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bottineau, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.