Crosby Clinic | |
702 1st St. Sw Crosby ND 58730-0658 | |
(701) 965-6349 | |
(701) 965-6407 |
Full Name | Crosby Clinic |
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Speciality | Clinic/Center |
Location | 702 1st St. Sw, Crosby, North Dakota |
Authorized Official Name and Position | Keith Baker (ASSISTANT ADMINISTRATOR) |
Authorized Official Contact | 7019656349 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Crosby Clinic Po Box C Crosby ND 58730-0658 Ph: (701) 965-6349 | Crosby Clinic 702 1st St. Sw Crosby ND 58730-0658 Ph: (701) 965-6349 |
NPI Number | 1184737231 |
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Provider Enumeration Date | 08/15/2006 |
Last Update Date | 09/15/2011 |
Medicare PECOS PAC ID | 4486565645 |
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Medicare Enrollment ID | O20040423001224 |
Identifier | Type | State | Issuer |
---|---|---|---|
1184737231 | NPI | - | NPPES |
5082 | Medicaid | ND | |
009571 | Other | ND | NORTH DAKOTA BLUE CROSS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | 353413 (North Dakota) | Primary |
Provider Name | Jacquelyn Barnhart |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1225030521 PECOS PAC ID: 1052365087 Enrollment ID: I20050311000423 |
Provider Name | Mark G Peterson |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1134182355 PECOS PAC ID: 7214979616 Enrollment ID: I20050525001101 |
Provider Name | Brian L Selland |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1710052626 PECOS PAC ID: 5092819276 Enrollment ID: I20071009000388 |
Provider Name | Brian M Sullivan |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1972761252 PECOS PAC ID: 2062538127 Enrollment ID: I20120801000057 |
Provider Name | Michael J Magidow |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1649479296 PECOS PAC ID: 8921148628 Enrollment ID: I20130225000162 |
Provider Name | Benjamin J Krogh |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1013003540 PECOS PAC ID: 9234192055 Enrollment ID: I20140818000358 |
Provider Name | Matthew Frederick Feller |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1659323970 PECOS PAC ID: 2567532930 Enrollment ID: I20150120002056 |
Provider Name | Stanley R Stevens |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1114288768 PECOS PAC ID: 3476707530 Enrollment ID: I20160128001175 |
Provider Name | Christine L Knudsvig |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1134202559 PECOS PAC ID: 0143378299 Enrollment ID: I20160205000624 |
Provider Name | Cori Randall |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1083182174 PECOS PAC ID: 2466798475 Enrollment ID: I20190111003070 |
Provider Name | Janie M Sova |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1760109383 PECOS PAC ID: 2769852409 Enrollment ID: I20221221001813 |
Crosby Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 702 1st St. Sw, Crosby, ND 58730 Phone: 701-965-6349 Fax: 701-965-6407 |