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LIVING WELL DAKOTA
NPI 1619647211
Clinic/Center in Bismarck, ND

Active since September 15, 2021CLIA 35D2247496 · Waiver
1140 W CAPITOL AVE, BISMARCK, ND 58501(701) 989-8251 Get Directions Write a Review

NPPES record last updated: September 15, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Living Well Dakota NPPES

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

LIVING WELL DAKOTA (NPI 1619647211) is a healthcare organization registered as a clinic/center in Bismarck, North Dakota and active in the NPI registry since September 2021. The organization holds a CLIA Waiver certificate valid through January 5, 2028 and lists Jody Tanner, Provider, as its authorized official.

NPPES Registry Identity

NPI1619647211
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameLIVING WELL DAKOTA
Location Address1140 W CAPITOL AVEBismarck, ND 58501-1306
Mailing Address6612 Dakota Country DrBismarck, ND 58503-1550 · (701) 989-8251
Phone(701) 989-8251
Organization SubpartNo
Authorized OfficialJody TannerProvider · (701) 989-8251
Enumeration DateSeptember 15, 2021
NPPES CertifiedSeptember 15, 2021
✔ NPI 1619647211 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
1140 W CAPITOL AVE, Bismarck, ND 58501
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of North Dakota, Sanford Health Plan.Insurance ›

CLIA Laboratory Certificates CMS CLIA

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 35D2247496

Living Well Dakota · Bismarck, ND
Active · expires Jan 5, 2028
CLIA Number35D2247496
Laboratory TypePhysician Office
Certificate Effective DateJanuary 6, 2026
Certificate Expiration DateJanuary 5, 2028
Laboratory DirectorJody Tanner
Laboratory Phone(701) 204-7706
Laboratory LocationLiving Well Dakota1140 W Capitol Ave, Bismarck, ND 58501
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 8

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

GERARD F KOORBUSCH DDS, MBA
Dentist (Oral and Maxillofacial Surgery)
1140 W CAPITOL AVE
BISMARCK, ND 58501
Burleigh County (701) 258-7220
FACE AND JAW SURGEONS PC
Dentist (Oral and Maxillofacial Surgery)
1140 W CAPITOL AVE
BISMARCK, ND 58501
Burleigh County (701) 258-7220
EMBRACE WELLNESS PLLC
Clinic/Center (Primary Care)
1140 W CAPITOL AVE
BISMARCK, ND 58501
Burleigh County (701) 751-7244
EMPOWER PHYSICAL THERAPY LLC
Physical Therapist
1140 W CAPITOL AVE
BISMARCK, ND 58501
Burleigh County (701) 400-5433
PEAKE OT MYOFASCIAL RELEASE
Occupational Therapist
1140 W CAPITOL AVE
BISMARCK, ND 58501
Burleigh County (701) 450-1900
CASSANDRA B HAIDER NP-C
Nurse Practitioner
1140 W CAPITOL AVE
BISMARCK, ND 58501
Burleigh County (701) 751-7244
MICHELLE M PEAKE OTR/L
Occupational Therapist
1140 W CAPITOL AVE
BISMARCK, ND 58501
Burleigh County (701) 450-1900
MICHELLE D MAIER NP
Nurse Practitioner (Family)
1140 W CAPITOL AVE
BISMARCK, ND 58501
Burleigh County (701) 751-7244

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 Living Well Dakota's NPI number?

The NPI number for Living Well Dakota is 1619647211. It was assigned to this organization in the NPPES registry on September 15, 2021.

Where is Living Well Dakota located?

Living Well Dakota is located at 1140 W Capitol Ave, Bismarck, ND 58501. The listed phone number is (701) 989-8251.

What is Living Well Dakota's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Does Living Well Dakota hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 35D2247496) is associated with this NPI, valid through January 5, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Living Well Dakota accept?

Health plans from Blue Cross Blue Shield of North Dakota and Sanford Health Plan list Living Well Dakota as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Living Well Dakota was last updated on September 15, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.