ALTRU HEALTH SYSTEM — NPI 1043309552 (Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center in GRAND FORKS, ND)

CMS-1500 Box 24J / 33a • NPI

1043309552

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

261Q00000X (CMS 70)

Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center

Box 32 Service Location & ZIP+4

1300 S COLUMBIA RD, GRAND FORKS, ND, 58201-4012

✓ 9-Digit EDI 837 ZIP+4 (58201-4012)

Practice Phone & Referral Fax

(701) 780-5000

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1043309552 (ALTRU HEALTH SYSTEM) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1043309552` (NPI-2 Organization / Facility)
Provider / Legal Name	ALTRU HEALTH SYSTEM
Plain-English Specialty	Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center NUCC Code: `261Q00000X` (Clinic/Center)
Certifying / Licensing Body	Accreditation Association for Ambulatory Health Care (AAAHC) / CMS
Practice Location Address	1300 S COLUMBIA RD, GRAND FORKS, ND, 58201-4012
Practice Telephone / Fax	Tel: (701) 780-5000
Administrative Mailing Address	PO BOX 860939, MINNEAPOLIS, MN, 55486-0939
Enumeration & Last Sync	Enumerated: 2006-10-12 \| CMS Record Updated: 2026-02-02
Authorized Official	DEREK GOEBEL (Chief Financial Officer)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

1300 S COLUMBIA RD, GRAND FORKS, ND, 58201-4012

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Plain-English Taxonomy & CMS Crosswalk (261Q00000X)

What Does Taxonomy Code 261Q00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 261Q00000X translates to:
"Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 70 (Clinic or Group Practice)
Certifying / Accrediting Authority: Accreditation Association for Ambulatory Health Care (AAAHC) / CMS
Clinical Scope: Same-day outpatient consultations, urgent walk-in medical care, vaccinations, and day-case diagnostic procedures.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (ALTRU HEALTH SYSTEM)

Typical CPT / Diagnostic Procedures:

Walk-In Urgent Care Evaluation, Point-of-Care Testing & X-Ray
Same-Day Ambulatory Endoscopy, Cataract & Minor Surgical Procedures

Common Therapeutic Classes:

Outpatient Oral Antimicrobials, Analgesics, Nebulizers & Vaccines

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`208G00000X` — Thoracic Surgery (Cardiothoracic Vascular Surgery) Plain English: Licensed & Credentialed Allopathic & Osteopathic Physicians — Thoracic Surgery (Cardiothoracic Vascular Surgery)	State: N/A \| License: `Verified` \| Primary: Secondary
`207K00000X` — Allergy & Immunology Plain English: Licensed & Credentialed Allopathic & Osteopathic Physicians — Allergy and Immunology	State: N/A \| License: `Verified` \| Primary: Secondary
`207V00000X` — Obstetrics & Gynecology Plain English: Board-Certified Obstetrician & Gynecologist (Women's Health & Pregnancy Doctor)	State: N/A \| License: `Verified` \| Primary: Secondary
`207R00000X` — Internal Medicine Plain English: Board-Certified Internist (Adult Diagnostic & Chronic Disease Physician)	State: N/A \| License: `Verified` \| Primary: Secondary
`208600000X` — Surgery Plain English: Board-Certified Orthopedic Surgeon (Bone, Joint, Spine & Sports Injury Surgeon)	State: N/A \| License: `Verified` \| Primary: Secondary
`207L00000X` — Anesthesiology Plain English: Board-Certified Anesthesiologist & Interventional Pain Specialist	State: N/A \| License: `Verified` \| Primary: Secondary
`207RH0003X` — Internal Medicine, Hematology & Oncology Plain English: Board-Certified Internist (Adult Diagnostic & Chronic Disease Physician)	State: N/A \| License: `Verified` \| Primary: Secondary
`207X00000X` — Orthopaedic Surgery Plain English: Board-Certified Orthopedic Surgeon (Bone, Joint, Spine & Sports Injury Surgeon)	State: N/A \| License: `Verified` \| Primary: Secondary
`207Q00000X` — Family Medicine Plain English: Board-Certified Family Medicine Physician (All-Ages Primary Care Doctor)	State: N/A \| License: `Verified` \| Primary: Secondary
`261Q00000X` — Clinic/Center Plain English: Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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ALTRU HEALTH SYSTEM (NPI #1043309552)