OrganizationActive
Tracie M Mallberg MD PC
NPI 1023282969 · Primary Care Clinic/Center · West Fargo, ND
Provider details
- NPI number
- 1023282969
- Entity type
- Organization
- Primary specialty
- Primary Care Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Tracie Mallberg, President(701) 356-5459
- License
- 9395 (ND)
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Detailed profile(87/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
550 13th Ave E
West Fargo, ND 58078-3360
Phone: (701) 356-5459
Fax: (701) 356-3764
Street-level locationGet directions
Mailing address
550 13th Ave E
West Fargo, ND 58078-3360
Other names (DBA / former)
- Doing business as
- Lilycare Clinic
Registry dates
- Enumerated
- 2008-04-22
- Last updated
- 2008-08-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.