| St Luke's Hospital | |
|
702 1st St. Sw Crosby ND 58730-0658 | |
| (701) 965-6349 | |
| (701) 965-6407 |
| Full Name | St Luke's Hospital |
|---|---|
| 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 |
|---|---|
| St Luke's Hospital Po Box C Crosby ND 58730-0658 Ph: (701) 965-6349 | St Luke's Hospital 702 1st St. Sw Crosby ND 58730-0658 Ph: (701) 965-6349 |
| NPI Number | 1184737231 |
|---|---|
| Provider Enumeration Date | 08/15/2006 |
| Last Update Date | 09/15/2011 |
| Medicare PECOS PAC ID | 4486565645 |
|---|---|
| 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 |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225030521 PECOS PAC ID: 1052365087 Enrollment ID: I20050311000423 |
| Provider Name | Mark G Peterson |
|---|---|
| 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 |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649479296 PECOS PAC ID: 8921148628 Enrollment ID: I20130225000162 |
| Provider Name | Benjamin J Krogh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013003540 PECOS PAC ID: 9234192055 Enrollment ID: I20140818000358 |
| Provider Name | Matthew Frederick Feller |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659323970 PECOS PAC ID: 2567532930 Enrollment ID: I20150120002056 |
| Provider Name | Stanley R Stevens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114288768 PECOS PAC ID: 3476707530 Enrollment ID: I20160128001175 |
| Provider Name | Christine L Knudsvig |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134202559 PECOS PAC ID: 0143378299 Enrollment ID: I20160205000624 |
| Provider Name | Cori Randall |
|---|---|
| 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 |
St Luke's Hospital 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 |