| Mid Dakota Clinic, Inc. | |
|
401 N 9th St Bismarck ND 58501-4507 | |
| (701) 712-4500 | |
| (701) 712-4011 |
| Full Name | Mid Dakota Clinic, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 401 N 9th St, Bismarck, North Dakota |
| Authorized Official Name and Position | William Heegaard (PRESIDENT) |
| Authorized Official Contact | 7013644554 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mid Dakota Clinic, Inc. 401 N 9th St Bismarck ND 58501-4507 Ph: (701) 712-4500 | Mid Dakota Clinic, Inc. 401 N 9th St Bismarck ND 58501-4507 Ph: (701) 712-4500 |
| NPI Number | 1275587826 |
|---|---|
| Provider Enumeration Date | 05/19/2006 |
| Last Update Date | 10/25/2022 |
| Medicare PECOS PAC ID | 9638072895 |
|---|---|
| Medicare Enrollment ID | O20040127001063 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275587826 | NPI | - | NPPES |
| 11238 | Medicaid | ND |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | John D Botsford |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639125321 PECOS PAC ID: 4880599604 Enrollment ID: I20031210000682 |
| Provider Name | David Mathison |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295847861 PECOS PAC ID: 8921905241 Enrollment ID: I20031216000077 |
| Provider Name | Jeremiah J Penn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043237522 PECOS PAC ID: 3375445778 Enrollment ID: I20040126000353 |
| Provider Name | Ferdinand Addo |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1760461388 PECOS PAC ID: 8921992918 Enrollment ID: I20040211000112 |
| Provider Name | Betty Kemper |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1033155205 PECOS PAC ID: 3779478706 Enrollment ID: I20040218000922 |
| Provider Name | Robert Tanous |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174550180 PECOS PAC ID: 8022094143 Enrollment ID: I20040628001485 |
| Provider Name | Jay Steckler |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1083634521 PECOS PAC ID: 4880665561 Enrollment ID: I20040805000018 |
| Provider Name | Joseph M Ebertz |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1649224809 PECOS PAC ID: 0547163156 Enrollment ID: I20041216000661 |
| Provider Name | Gaylord J Kavlie |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1760437198 PECOS PAC ID: 9537127923 Enrollment ID: I20050103000240 |
| Provider Name | Donald H Grenz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699720995 PECOS PAC ID: 6901840768 Enrollment ID: I20050614000215 |
| Provider Name | Steven Kendall Hamar |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1063469336 PECOS PAC ID: 0749268134 Enrollment ID: I20050615000065 |
| Provider Name | Bernadette A Kraft |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1366484727 PECOS PAC ID: 5597791533 Enrollment ID: I20050712000358 |
| Provider Name | Khalid Naseer |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1851341366 PECOS PAC ID: 9335177047 Enrollment ID: I20050802001276 |
| Provider Name | Jerry R Town |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1841343191 PECOS PAC ID: 6103847926 Enrollment ID: I20051208000379 |
| Provider Name | Ralph Dunnigan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1932151586 PECOS PAC ID: 2668483876 Enrollment ID: I20060531000109 |
| Provider Name | Brian J Hebert |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235177577 PECOS PAC ID: 2668475468 Enrollment ID: I20060817000045 |
| Provider Name | Julia M Schwartz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134168685 PECOS PAC ID: 5193728996 Enrollment ID: I20060817000059 |
| Provider Name | Shelly A Seifert |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245286764 PECOS PAC ID: 7618971540 Enrollment ID: I20060908000036 |
| Provider Name | Heather A Freitag |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1063457000 PECOS PAC ID: 3870598097 Enrollment ID: I20060921000641 |
| Provider Name | Gordon D Leingang |
|---|---|
| Provider Type | Practitioner - Other (physician) |
| Provider Identifiers | NPI Number: 1538187125 PECOS PAC ID: 6305812793 Enrollment ID: I20061102000044 |
| Provider Name | Theresa A Borrowman |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1083694269 PECOS PAC ID: 2860490646 Enrollment ID: I20061110000406 |
| Provider Name | Kevin Longie |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326176223 PECOS PAC ID: 1254427404 Enrollment ID: I20071018000564 |
| Provider Name | Kelly B Longie |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427182823 PECOS PAC ID: 7113013376 Enrollment ID: I20071018000686 |
| Provider Name | Jessica A Lervick |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1184801045 PECOS PAC ID: 4587692116 Enrollment ID: I20080401000783 |
| Provider Name | Steven Yearsley |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1720131451 PECOS PAC ID: 0143252965 Enrollment ID: I20081217000041 |
| Provider Name | Carmen Repnow |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1568616670 PECOS PAC ID: 1052474962 Enrollment ID: I20090120000152 |
| Provider Name | Nicole Olson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1346478500 PECOS PAC ID: 4082767934 Enrollment ID: I20090724000720 |
| Provider Name | Marissa A Wisdom |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1972713337 PECOS PAC ID: 5395891683 Enrollment ID: I20090929000443 |
| Provider Name | Melissa Ulberg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457583460 PECOS PAC ID: 6305982604 Enrollment ID: I20090929000646 |
| Provider Name | Cathy A Deics |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1922271501 PECOS PAC ID: 9638201486 Enrollment ID: I20100714001071 |
| Provider Name | Karen L Jacobus |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1649583006 PECOS PAC ID: 8022134030 Enrollment ID: I20100928000480 |
| Provider Name | Mark A Erickstad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700824984 PECOS PAC ID: 5193917169 Enrollment ID: I20101008000389 |
| Provider Name | Jason Moe |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1396763975 PECOS PAC ID: 5294928941 Enrollment ID: I20101026000776 |
| Provider Name | Kristie A Toman |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1548452733 PECOS PAC ID: 4789749938 Enrollment ID: I20101115000869 |
| Provider Name | Jerry M Obritsch |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1093769291 PECOS PAC ID: 7719902170 Enrollment ID: I20101207000164 |
| Provider Name | Steven J Scherr |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083654792 PECOS PAC ID: 9739378803 Enrollment ID: I20110105001275 |
| Provider Name | Douglas L Moen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477506137 PECOS PAC ID: 7012106826 Enrollment ID: I20110110000749 |
| Provider Name | John Erickstad |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457399644 PECOS PAC ID: 3173702289 Enrollment ID: I20110121000224 |
| Provider Name | Laura M Fuerstenberg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619912326 PECOS PAC ID: 4981872843 Enrollment ID: I20110719000816 |
| Provider Name | Kevin P Chaussee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962424440 PECOS PAC ID: 9537339221 Enrollment ID: I20110907001590 |
| Provider Name | Stephanie A Traxinger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366608465 PECOS PAC ID: 4082885710 Enrollment ID: I20110928000838 |
| Provider Name | Amy Juelson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1912032970 PECOS PAC ID: 4789850074 Enrollment ID: I20120109000648 |
| Provider Name | Paul Jondahl |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780638981 PECOS PAC ID: 7214194935 Enrollment ID: I20120208000762 |
| Provider Name | Lori Smith |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1548297302 PECOS PAC ID: 9739346453 Enrollment ID: I20120208000802 |
| Provider Name | Traci L Craigmile |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891062089 PECOS PAC ID: 6608034087 Enrollment ID: I20120215000490 |
| Provider Name | Megan Strand |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1841447166 PECOS PAC ID: 5496903965 Enrollment ID: I20120907000574 |
| Provider Name | Jill Steinle |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1437314473 PECOS PAC ID: 8123276466 Enrollment ID: I20120912000192 |
| Provider Name | Jenna L Ficek |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1871830422 PECOS PAC ID: 4789839812 Enrollment ID: I20130221000272 |
| Provider Name | Andrew J Wilder |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1275607509 PECOS PAC ID: 9234326745 Enrollment ID: I20130830000370 |
| Provider Name | Stephanie Delvo |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1336377357 PECOS PAC ID: 6002044278 Enrollment ID: I20140115000340 |
| Provider Name | Matthew Hamar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154618130 PECOS PAC ID: 2163646464 Enrollment ID: I20140606000163 |
| Provider Name | Jean M Gustafson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437445442 PECOS PAC ID: 8022236892 Enrollment ID: I20140820002441 |
| Provider Name | Eric Lutzwick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568877827 PECOS PAC ID: 6608094768 Enrollment ID: I20140902002236 |
| Provider Name | Ryan M Clauson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629230081 PECOS PAC ID: 8325260490 Enrollment ID: I20141230001991 |
| Provider Name | Alexis K Witt |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1033515788 PECOS PAC ID: 2062727951 Enrollment ID: I20150821012890 |
| Provider Name | Amandu Schmitcke |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1487948832 PECOS PAC ID: 7517274061 Enrollment ID: I20150915002959 |
| Provider Name | Andrew D Knudsen |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1407111321 PECOS PAC ID: 7911126149 Enrollment ID: I20150919000194 |
| Provider Name | Jenny Schmidt |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1902257454 PECOS PAC ID: 0941594063 Enrollment ID: I20160811001263 |
| Provider Name | Amanda L Levey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316488083 PECOS PAC ID: 1658657291 Enrollment ID: I20170413000794 |
| Provider Name | Ashley Elizabeth Pierson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1447493135 PECOS PAC ID: 0244460152 Enrollment ID: I20170815003366 |
| Provider Name | Heather Sandness-nelson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1265872212 PECOS PAC ID: 8527332386 Enrollment ID: I20170919000278 |
| Provider Name | Walter Moore |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1326021841 PECOS PAC ID: 9335182245 Enrollment ID: I20180122002122 |
| Provider Name | Teresa Morris Seefeld |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1033260146 PECOS PAC ID: 8022379221 Enrollment ID: I20180305001073 |
| Provider Name | Kristy L Schuh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639101959 PECOS PAC ID: 4587665872 Enrollment ID: I20180807000855 |
| Provider Name | Laura E Knutson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1174941264 PECOS PAC ID: 3779855382 Enrollment ID: I20181023002146 |
| Provider Name | Abby R Renner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023583101 PECOS PAC ID: 4183969348 Enrollment ID: I20181218000299 |
| Provider Name | Jennifer A Westmoreland |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1942352679 PECOS PAC ID: 8921994179 Enrollment ID: I20190213003319 |
| Provider Name | Taylor L Jenner |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1912244898 PECOS PAC ID: 9931344108 Enrollment ID: I20190923000795 |
| Provider Name | Kayla M Cofer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023649860 PECOS PAC ID: 9234566647 Enrollment ID: I20200225001433 |
| Provider Name | Rachel M Marohl |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1023469715 PECOS PAC ID: 2466745369 Enrollment ID: I20200828002708 |
| Provider Name | Stephanie L Jensen |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1346856002 PECOS PAC ID: 1850711870 Enrollment ID: I20201013002308 |
| Provider Name | April Kautzman |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1982209300 PECOS PAC ID: 5890104533 Enrollment ID: I20210508000015 |
| Provider Name | Jacquelyn K Haugen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558022962 PECOS PAC ID: 7911392394 Enrollment ID: I20220322000961 |
| Provider Name | Jeanie M Larson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881347995 PECOS PAC ID: 4082009360 Enrollment ID: I20220323002418 |
| Provider Name | Kayla V Holzer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649901869 PECOS PAC ID: 8820470602 Enrollment ID: I20220727001754 |
Lung Disease And Infection Consultants Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 210 S 12th St, Bismarck, ND 58504 Phone: 701-223-4234 Fax: 701-222-0712 | |
Prairie Assisted Living Services Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4914 Amberglow Dr, Bismarck, ND 58503 Phone: 701-226-9804 Fax: 701-751-1307 | |
Inspired Life Wellness Clinic, Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3100 Moonstone Ln, Bismarck, ND 58503 Phone: 701-989-4354 Fax: 701-213-4335 | |
Essentia Health Mid Dakota Bismarck 9th St Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 401 N 9th St, Bismarck, ND 58501 Phone: 701-712-4500 | |
Wellness Rediscovered P.l.l.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 705 E Main Ave, Bismarck, ND 58501 Phone: 701-269-9455 | |
Tru Health & Wellness Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 705 E Main Ave, Bismarck, ND 58501 Phone: 701-226-4432 | |
Lifeways Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1001 Gateway Avenue, Bismarck, ND 58503 Phone: 701-751-3271 |