KEVIN G PANICO (NPI# 1225120652) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225120652 |
| Entity Type | Individual |
| Full Name | KEVIN G PANICO |
| Credential | MD |
| Practice Address |
960 S Columbia Rd Grand Forks ND 58201-4030 |
| Mailing Address |
2401 Demers Ave Grand Forks ND 58201-4183 |
| Practice Telephone | 7017806000 |
| Mailing Telephone | 7017801891 |
| Enumeration Date | 2006-09-30 |
| Last Update Date | 2020-09-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
10035 | ND | Allopathic & Osteopathic Physicians |
| Street Address |
960 S COLUMBIA RD |
| City | GRAND FORKS |
| State | ND |
| Zip Code | 58201-4030 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023504073 | Kayla Clausen | Nurse Practitioner | 960 S Columbia Rd, Grand Forks, ND 58201-4030 | 2018-07-02 |
| 1699214403 | Altru Health System | Clinic/Center | 960 S Columbia Rd, Grand Forks, ND 58201-4030 | 2017-02-14 |
| 1447652300 | Nicole Hylden | Nurse Practitioner | 960 S Columbia Rd, Grand Forks, ND 58201-4030 | 2014-09-23 |
| 1134520745 | Karine Darbinyan | Internal Medicine | 960 S Columbia Rd, Grand Forks, ND 58201 | 2014-09-15 |
| 1154639359 | Georgia Jaquette Smith | Registered Nurse | 960 S Columbia Rd, Grand Forks, ND 58201-4030 | 2010-09-22 |
| 1427252014 | Grant Richard Seeger | Radiology | 960 S Columbia Rd, Grand Forks, ND 58201-4030 | 2007-06-14 |
| 1336285931 | Jacqueline R Devine-roberts | Nurse Practitioner | 960 S Columbia Rd, Grand Forks, ND 58201-4030 | 2007-01-30 |
| 1093801359 | Daniel J Walsh | Internal Medicine | 960 S Columbia Rd, Grand Forks, ND 58201-4030 | 2006-10-05 |
| 1184710444 | Marshall Winchester | Radiology | 960 S Columbia Rd, Grand Forks, ND 58201-4030 | 2006-10-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255965398 | Development Homes Inc | Intermediate Care Facility, Mentally Retarded | 5509 Cottonwood Street, Grand Forks, ND 58201 | 2020-02-27 |
| 1932753779 | Lydia Pansegrau | Occupational Therapist | 2950 36th Ave S, Apt A-11, Grand Forks, ND 58201 | 2019-07-30 |
| 1407416019 | Kristina Aikens | Optometrist | 1820 S 42nd St, Grand Forks, ND 58201 | 2019-06-17 |
| 1861963209 | Jessica Kovsky | Occupational Therapist | 1375 S Columbia Rd- Altru Performance Center, Grand Forks, ND 58201 | 2018-12-11 |
| 1609345834 | Altru Specialty Services, Inc | Durable Medical Equipment & Medical Supplies | 1375 South Columbia Road, Suite A, Grand Forks, ND 58201 | 2018-11-16 |
| 1225523004 | Alicia Mae Mack | Registered Nurse | 212 S. 4th St. Suite 301, Spectra Health, Grand Forks, ND 58201 | 2018-06-25 |
| 1396260808 | Amber White | Behavior Technician | 2016 S Washington St., Grand Forks, ND 58201 | 2017-08-04 |
| 1225579840 | Kathleen Suzanne Tillman | Psychologist | 2100 S Columbia Road, Suite 202, Family Institute, PC, Grand Forks, ND 58201 | 2017-03-15 |
| 1881148906 | Melissa Pytlik Monson | Physician Assistant | 1380 S Columbia Rd - Altru Family Medcine Center, Grand Forks, ND 58201 | 2016-08-05 |
| 1477936029 | Laura Jane Carlson | Nurse Practitioner | 3165 Demers Avenue - Truyu Aesthetic Center, Grand Forks, ND 58201 | 2015-07-01 |
| Find all providers in zip 58201 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427122266 | Anil Potti | Internal Medicine | 1451 44th Ave S Ste E, Grand Forks, ND 58201-3434 | 2006-11-20 |
| 1134520745 | Karine Darbinyan | Internal Medicine | 960 S Columbia Rd, Grand Forks, ND 58201 | 2014-09-15 |
| 1457501827 | Ivan Jose Bustillo Chams | Internal Medicine | 1000 South Columbia Road, Grand Forks, ND 58206-6002 | 2008-09-23 |
| 1093801359 | Daniel J Walsh | Internal Medicine | 960 S Columbia Rd, Grand Forks, ND 58201-4030 | 2006-10-05 |
| 1669563771 | Todor Nedeltchev Dentchev | Internal Medicine | 960 S Columbia Rd - Altru Cancer Center, Grand Forks, ND 58201 | 2006-09-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245397041 | Billings Clinic | Internal Medicine | 1305 15th Avenue W, Williston, ND 58801 | 2007-01-02 |
| 1013938752 | Howard L Russell | Internal Medicine | 820 N 4th St, Fargo, ND 58122-0001 | 2006-07-21 |
| 1922025907 | Anu G Gaba | Internal Medicine | 820 4th St N, Fargo, ND 58122-0001 | 2006-07-16 |
| 1982917506 | Abdallah Abou Zahr | Internal Medicine | 820 4th St N, Fargo, ND 58102-4539 | 2010-07-24 |
| 1922236793 | Peter C Kurniali | Internal Medicine | 300 N 7th St, Bismarck, ND 58501-4439 | 2009-06-30 |
| 1154505360 | F E K Addo Md PC | Internal Medicine | 300 W Century Ave, Bismarck, ND 58503-1401 | 2007-12-24 |
| 1043426034 | Amit Panwalkar | Internal Medicine | 820 4th St N, Fargo, ND 58102-4539 | 2007-05-15 |
| 1457429680 | Edward J Wos | Internal Medicine | 222 N 7th St, Bismarck, ND 58501-4436 | 2006-12-04 |
| 1417027988 | John T Reynolds | Internal Medicine | 222 N 7th St, Bismarck, ND 58501-4436 | 2006-11-09 |
| 1093813743 | Baruti Serabe | Internal Medicine | 222 N 7th St, Bismarck, ND 58501-4436 | 2006-09-20 |
| Find all providers with the same taxonomy | ||||
| City | GRAND FORKS |
| Zip Code | 58201 |
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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.