JENNIFER BROTTLUND (NPI# 1114288933) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114288933 |
| Entity Type | Individual |
| Full Name | JENNIFER BROTTLUND |
| Credential | MD |
| Practice Address |
3955 56th St S Ste D Fargo ND 58104-4845 |
| Mailing Address |
Po Box 6001 Fargo ND 58108-6001 |
| Practice Telephone | 7012342000 |
| Practice Fax Number | 7012343515 |
| Mailing Telephone | 7013643300 |
| Enumeration Date | 2012-06-07 |
| Last Update Date | 2019-11-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 13699 | ND | Allopathic & Osteopathic Physicians |
| Street Address |
3955 56TH ST S STE D |
| City | FARGO |
| State | ND |
| Zip Code | 58104-4845 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144592486 | Sara B Hansen | Nurse Practitioner | 3955 56th St S Ste D, Fargo, ND 58104-4845 | 2012-02-02 |
| 1154954352 | Larissa Jane Marsh | Social Worker | 3955 56th St S Ste D, Fargo, ND 58104-4845 | 2020-02-16 |
| 1538699566 | Jenny Steele | Family Medicine | 3955 56th St S Ste D, Fargo, ND 58104-4845 | 2017-06-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043837347 | Pinnacle Therapy & Wellness, Pllc | Physical Therapist | 4500 36th Ave S Suite 100, Fargo, ND 58104 | 2020-07-02 |
| 1619509858 | Patricia Helen Bathie | Counselor | 4243 Auburn Ave., Fargo, ND 58104 | 2020-02-05 |
| 1346892866 | Elizabeth Olis | Registered Nurse | 2633 55th St. S, Apartment 202, Fargo, ND 58104 | 2019-07-15 |
| 1780247023 | Keith Kirimi Ndege | Physical Therapy Assistant | 5225 23rd Ave South, Fargo, ND 58104 | 2019-04-22 |
| 1346728557 | Ms4 Pllc | Pharmacy | 4476 31st Avenue South, Suite #105, Fargo, ND 58104 | 2018-07-31 |
| 1891286977 | Jessica Rae Majidian | Dentist | 3030 49th St S, Fargo, ND 58104 | 2018-05-23 |
| 1821588500 | Alissa Nichole Larson | Pharmacist | 5675 26th Ave S St. 136a, Fargo, ND 58104 | 2018-05-17 |
| 1790297430 | Northern Lights Dental | Dentist | 4150 19th Ave S, Suite 301, Fargo, ND 58104 | 2017-11-03 |
| 1619406733 | Cobalt Rehabilitation Hospital Fargo LLC | Rehabilitation Hospital | 4671 38th Street S, Fargo, ND 58104 | 2017-06-12 |
| 1790210318 | Homefield Health, LLC | Clinic/Center | 4141 31st Ave S., Ste 102, Fargo, ND 58104 | 2017-04-21 |
| Find all providers in zip 58104 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| 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. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679068035 | Rory Ratzlaff | Family Medicine | Sanford Health 737 Broadway N, Fargo, ND 58122-0001 | 2018-06-28 |
| 1710472725 | Shabnum Gupta | Family Medicine | Sanford Health 801 Broadway North, Fargo, ND 58122-0170 | 2018-06-22 |
| 1538661384 | Community Uplift Program | Family Medicine | 417 Main Ave Ste 401, Fargo, ND 58103-1956 | 2018-03-07 |
| 1841576279 | Michelle Vonrueden | Family Medicine | 1018 18th St S, Fargo, ND 58103-2926 | 2011-10-31 |
| 1801174768 | Vidya Vijayaraghavan | Family Medicine | 4689 38th Ave S, Fargo, ND 58104-8506 | 2011-07-26 |
| 1275762924 | Sreejith Gopi | Family Medicine | 4110 51st Avenue South, Fargo, ND 58104 | 2009-07-02 |
| 1356537781 | Terry L Wolff | Family Medicine | 2700 12th Ave Sw, Suite D, Fargo, ND 58103 | 2007-09-19 |
| 1144436338 | Daniel Wilfred Herold | Family Medicine | 225 4th Ave N, Fargo Meps, Fargo, ND 58102-4841 | 2007-05-15 |
| 1679619860 | Carl John Fedyszyn, M.d.,p.c. | Family Medicine | 4550 47th St S Apt 102, Fargo, ND 58104-4360 | 2007-01-29 |
| 1417040189 | Michelle M Radke | Family Medicine | 1711 Gold Drive South Suite 160, Fargo, ND 58103 | 2006-10-02 |
| Find all providers in FARGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.