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331 4th Ave E Trenton ND 58853-9998 | |
| (701) 774-0461 | |
| (701) 774-0461 |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 331 4th Ave E, Trenton, North Dakota |
| Authorized Official Name and Position | Kelcey Lawrence (ERS) |
| Authorized Official Contact | 7015728316 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
331 4th Ave E Trenton ND 58853-9998 Ph: (701) 774-0461 | 331 4th Ave E Trenton ND 58853-9998 Ph: (701) 774-0461 |
| NPI Number | 1568574036 |
|---|---|
| Provider Enumeration Date | 08/31/2006 |
| Last Update Date | 12/30/2024 |
| Medicare PECOS PAC ID | 8022009430 |
|---|---|
| Medicare Enrollment ID | O20181114002611 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568574036 | NPI | - | NPPES |
| 35D0409330 | Other | ND | CLIA |
| 1312 | Medicaid | ND | |
| 287001 | Other | ND | BC/BS OF ND PROVIDER NUM. |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Dawn Marie Lafromboise |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1497818926 PECOS PAC ID: 7618991415 Enrollment ID: I20120613000305 |
| Provider Name | Carlos F Trevino |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285717116 PECOS PAC ID: 4183657703 Enrollment ID: I20181114003166 |
| Provider Name | Brandy Anne Shahin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306286448 PECOS PAC ID: 1355584483 Enrollment ID: I20181207001095 |
| Provider Name | Michael D Lapan |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1811981681 PECOS PAC ID: 1658415849 Enrollment ID: I20181210002141 |
| Provider Name | Nora E Keating |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710911037 PECOS PAC ID: 8921195108 Enrollment ID: I20181213000991 |
| Provider Name | Misty K Falcon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417983164 PECOS PAC ID: 5395728059 Enrollment ID: I20210826000442 |
| Provider Name | Chloe Senn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437803327 PECOS PAC ID: 5890149835 Enrollment ID: I20230926001273 |
| Provider Name | Martha Leigh Nugent |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114580701 PECOS PAC ID: 0042648677 Enrollment ID: I20240311002867 |