| Garrison Family Clinic | |
|
437 3rd Ave Se Garrison ND 58540-7235 | |
| (701) 463-2245 | |
| (701) 463-6543 |
| Full Name | Garrison Family Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 437 3rd Ave Se, Garrison, North Dakota |
| Authorized Official Name and Position | Tod S Graeber (ADMINISTRATOR) |
| Authorized Official Contact | 7014636505 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Garrison Family Clinic 437 3rd Ave Se Po Box 9 Garrison ND 58540-7235 Ph: (701) 463-2245 | Garrison Family Clinic 437 3rd Ave Se Garrison ND 58540-7235 Ph: (701) 463-2245 |
| NPI Number | 1952381873 |
|---|---|
| Provider Enumeration Date | 01/18/2006 |
| Last Update Date | 10/07/2014 |
| Medicare PECOS PAC ID | 0143206946 |
|---|---|
| Medicare Enrollment ID | O20040624000556 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952381873 | NPI | - | NPPES |
| 17125 | Medicaid | ND | |
| 9555 | Other | ND | BLUE CROSS/BLUE SHIELD |
| 5083 | Medicaid | ND |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | () | Primary |
| Provider Name | Jon E Dornacker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801804588 PECOS PAC ID: 2466400312 Enrollment ID: I20050106000874 |
| Provider Name | Susan G Wardner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235213695 PECOS PAC ID: 3870543507 Enrollment ID: I20050131000086 |
| Provider Name | Jacqueline D Nelson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1750586772 PECOS PAC ID: 2567568009 Enrollment ID: I20070731000372 |
| Provider Name | Ashley Murrey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619108420 PECOS PAC ID: 7416002530 Enrollment ID: I20090825000778 |
| Provider Name | Cassandra B Haider |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750698585 PECOS PAC ID: 3173716644 Enrollment ID: I20101018000692 |
| Provider Name | John R Smetana |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1164851457 PECOS PAC ID: 7911222898 Enrollment ID: I20150218000008 |
| Provider Name | Amanda H Schmidt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346616661 PECOS PAC ID: 9436467412 Enrollment ID: I20150925000144 |
| Provider Name | Arthur J Renner |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1013375500 PECOS PAC ID: 2264590033 Enrollment ID: I20160226002192 |
| Provider Name | Ermelinda Kerpi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508249707 PECOS PAC ID: 3072820752 Enrollment ID: I20180820001922 |
| Provider Name | Forrest L Hirsch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437645306 PECOS PAC ID: 6507117280 Enrollment ID: I20180919000903 |
| Provider Name | Kaitlyn Rae Wirtz |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1649839846 PECOS PAC ID: 7517295116 Enrollment ID: I20190820004064 |
| Provider Name | Michael L Hammer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730813130 PECOS PAC ID: 9032593140 Enrollment ID: I20220908000934 |
| Provider Name | Jennifer Cushman |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1265985626 PECOS PAC ID: 4082965645 Enrollment ID: I20230501001674 |
| Provider Name | Jenni Hetletved |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1164207338 PECOS PAC ID: 7911352026 Enrollment ID: I20231010001851 |
| Provider Name | Elizabeth Ashley Diffely |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245914563 PECOS PAC ID: 4284080292 Enrollment ID: I20231027000924 |
| Provider Name | Cassidy Lee Freeman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285524819 PECOS PAC ID: 6800394156 Enrollment ID: I20250807000973 |
| Provider Name | Jennifer Nicole Reynolds |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437048410 PECOS PAC ID: 6608378633 Enrollment ID: I20250908002740 |