| Tioga Medical Center | |
|
810 N Welo St Tioga ND 58852-7157 | |
| (701) 664-3368 | |
| (701) 664-3300 |
| Full Name | Tioga Medical Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 810 N Welo St, Tioga, North Dakota |
| Authorized Official Name and Position | Randall K. Pederson (PRESIDENT/CEO) |
| Authorized Official Contact | 7016643305 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tioga Medical Center Po Box 159 Tioga ND 58852-0159 Ph: (701) 664-3368 | Tioga Medical Center 810 N Welo St Tioga ND 58852-7157 Ph: (701) 664-3368 |
| NPI Number | 1245296078 |
|---|---|
| Provider Enumeration Date | 04/21/2006 |
| Last Update Date | 08/30/2016 |
| Medicare PECOS PAC ID | 1254390305 |
|---|---|
| Medicare Enrollment ID | O20041005001147 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245296078 | NPI | - | NPPES |
| 10158 | Medicaid | ND | |
| 00327001 | Other | ND | BCBSND |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 9333 (North Dakota) | Primary |
| Provider Name | Mark G Peterson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134182355 PECOS PAC ID: 7214979616 Enrollment ID: I20050525001101 |
| Provider Name | Nancy R Carlson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447667399 PECOS PAC ID: 2264659382 Enrollment ID: I20140814000510 |
| Provider Name | Robert H Rotering |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093144818 PECOS PAC ID: 9931405743 Enrollment ID: I20160303002658 |
| Provider Name | Ronald L Burinsky |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497775100 PECOS PAC ID: 8820092828 Enrollment ID: I20180530002466 |
| Provider Name | Jesse Mitchell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417503442 PECOS PAC ID: 9638409089 Enrollment ID: I20190926003035 |
| Provider Name | Andrew Mccoy |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1780883025 PECOS PAC ID: 2961646195 Enrollment ID: I20200611002870 |
| Provider Name | Amber Nelson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457132649 PECOS PAC ID: 2264881994 Enrollment ID: I20231206004368 |
Tioga Medical Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 810 N Welo St, Tioga, ND 58852 Phone: 701-664-3368 Fax: 701-664-3300 | |
Tioga Medical Center Hospital Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 810 N Welo St, Tioga, ND 58852 Phone: 701-664-3305 Fax: 701-664-2240 | |
Stewart Chiropractic Center Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 16 Nw 2nd St, Box 640, Tioga, ND 58852 Phone: 701-664-2311 |