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SPIRIT LAKE HEALTH CENTER MD
NPI 1053864108
Family Medicine in Fort Totten, ND

Active since July 25, 2016CLIA Certified · 3 labs
3883 74TH AVE NE, FORT TOTTEN, ND 58335(701) 766-1600(701) 766-1630 Get Directions Write a Review

NPPES record last updated: August 24, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Spirit Lake Health Center Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SPIRIT LAKE HEALTH CENTER MD (NPI 1053864108) is a healthcare organization registered as a family medicine in Fort Totten, North Dakota and active in the NPI registry since July 2016. The organization holds 3 active CLIA laboratory certificates and lists Michelle Belt, Ceo, as its authorized official.

NPPES Registry Identity

NPI1053864108
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameSPIRIT LAKE TRIBE
Location Address3883 74TH AVE NEFort Totten, ND 58335
Mailing AddressPo Box 309Fort Totten, ND 58335-0309 · (701) 766-1600 · Fax (701) 766-1630
Phone(701) 766-1600
Fax(701) 766-1630
Organization SubpartYes
Authorized OfficialMichelle BeltCeo · (701) 766-1600
Enumeration DateJuly 25, 2016
Last NPPES UpdateAugust 24, 2016
✔ NPI 1053864108 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
3883 74TH AVE NE, Fort Totten, ND 58335
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Other Names 1

Other NameSpirit Lake Health Center Md

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 3

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 35D2205951

Spirit Lake Health Center · Fort Totten, ND
Active · expires Dec 15, 2026
CLIA Number35D2205951
Laboratory TypeCommunity Clinic
Certificate Effective DateDecember 16, 2024
Certificate Expiration DateDecember 15, 2026
Laboratory DirectorJanet Dykstra
Laboratory Phone(701) 766-1600
Laboratory LocationSpirit Lake Health Center3883 74th Ave NE, Fort Totten, ND 58335
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Accreditation 35D0668547

Spirit Lake Health Center · Fort Totten, ND
Active · expires Sep 16, 2026
CLIA Number35D0668547
Laboratory TypeIhs
Certificate Effective DateSeptember 17, 2024
Certificate Expiration DateSeptember 16, 2026
Laboratory DirectorPaul D. Wilhelmi
Laboratory Phone(701) 766-1604
Laboratory LocationSpirit Lake Health Center3883 74th Ave NE, Fort Totten, ND 58335
CLIA data matches this NPI record on: Address Name
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Certificate of Waiver 35D0880432

Spirit Lake Health Center Diabetes Project · Fort Totten, ND
Active · expires Dec 13, 2027
CLIA Number35D0880432
Laboratory TypeAncillary Testing Site In Health Care Center
Certificate Effective DateDecember 14, 2025
Certificate Expiration DateDecember 13, 2027
Laboratory DirectorChallsey Scallon
Laboratory Phone(701) 766-1609
Laboratory LocationSpirit Lake Health Center Diabetes Project3883 74th Ave NE, Fort Totten, ND 58335
CLIA data matches this NPI record on: Address
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SPIRIT LAKE TRIBE
Physician Assistant
3883 74TH AVE NE
FORT TOTTEN, ND 58335
Benson County (701) 766-1600
RONNESHA OWUSU-KYEI DHS
Social Worker
3883 74TH AVE NE
FORT TOTTEN, ND 58335
Benson County (701) 766-1600
SPIRIT LAKE HEALTH CENTER
Clinic/Center (Health Service)
3883 74TH AVE NE
FORT TOTTEN, ND 58335
Benson County (701) 766-1600
ROBIN FIDDLER RN
Registered Nurse
3883 74TH AVE NE
FORT TOTTEN, ND 58335
Benson County (701) 766-1600
SPIRIT LAKE TRIBE
Clinic/Center (Health Service)
3883 74TH AVE NE
FORT TOTTEN, ND 58335
Benson County (701) 766-1600
SPIRIT LAKE HEALTH CENTER
Clinic/Center (Radiology, Mammography)
3883 74TH AVE NE
FORT TOTTEN, ND 58335
Benson County (701) 766-1600
SPIRIT LAKE TRIBE
Social Worker (Clinical)
3883 74TH AVE NE
FORT TOTTEN, ND 58335
Benson County (701) 766-1600
SARAH RUTH CAVANAUGH
Dentist
3883 74TH AVE NE
FORT TOTTEN, ND 58335
Benson County (701) 766-1615

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Spirit Lake Tribe's NPI number?

The NPI number for Spirit Lake Tribe is 1053864108. It was assigned to this organization in the NPPES registry on July 25, 2016. The provider is also known as Spirit Lake Health Center MD.

Where is Spirit Lake Tribe located?

Spirit Lake Tribe is located at 3883 74th Ave NE, Fort Totten, ND 58335. The listed phone number is (701) 766-1600.

What is Spirit Lake Tribe's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Spirit Lake Tribe hold CLIA laboratory certificates?

Yes. 3 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Spirit Lake Tribe was last updated on August 24, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.