SUSAN J DVORAK (NPI# 1528136538) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528136538 |
| Entity Type | Individual |
| Full Name | SUSAN J DVORAK |
| Credential | PA |
| Practice Address |
1000 S Columbia Rd Grand Forks ND 58201-4036 |
| Mailing Address |
Po Box 6002 Grand Forks ND 58206-6002 |
| Practice Telephone | 7017805345 |
| Practice Fax Number | 7017801942 |
| Mailing Telephone | 7017805345 |
| Mailing Fax Number | 7017801942 |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PAC0353 | ND | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ND | BCBS ND | 27352 | 01 |
| MN | BCBS MN | 11ND1DV | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144438672 | Susan Dvorak | Psychologist | 9120 W Hampton Ave, Suite 90, Milwaukee, WI 53225-4960 | 2007-05-18 |
| 1477588275 | Susan Vargo Dvorak | Dietitian, Registered | 2139 Auburn Ave, Cincinnati, OH 45219-2906 | 2006-07-11 |
| Street Address |
1000 S COLUMBIA RD |
| City | GRAND FORKS |
| State | ND |
| Zip Code | 58201-4036 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285636423 | Kirsten D Peterson | Internal Medicine | 1000 S Columbia Rd, Grand Forks, ND 58201-4032 | 2005-06-01 |
| 1942733852 | Melissa Vanwynsberghe | Occupational Therapist | 1000 S Columbia Rd, Grand Forks, ND 58201-4032 | 2017-04-07 |
| 1154862985 | Kevin Viken | Physical Therapist | 1000 S Columbia Rd, Grand Forks, ND 58201-4032 | 2017-03-13 |
| 1023567377 | Morgan Barry | Physical Therapy Assistant | 1000 S Columbia Rd, Grand Forks, ND 58201-4032 | 2016-09-28 |
| 1619423423 | Danielle Weinreis | Physical Therapy Assistant | 1000 S Columbia Rd, Grand Forks, ND 58201-4032 | 2016-08-31 |
| 1588022743 | Renae Elizabeth Johnson | Nurse Anesthetist, Certified Registered | 1000 S Columbia Rd, Grand Forks, ND 58201-4032 | 2016-02-03 |
| 1891161071 | Amaka Onyeka | Nurse Practitioner | 1000 S Columbia Rd, Grand Forks, ND 58201-4032 | 2015-08-11 |
| 1366837221 | Merri Vacura | Occupational Therapist | 1000 S Columbia Rd, Grand Forks, ND 58201-4032 | 2015-03-30 |
| 1750770319 | Marie Reuter | Speech-Language Pathologist | 1000 S Columbia Rd, Grand Forks, ND 58201-4032 | 2015-01-20 |
| 1841698933 | Kari Renfrow | Pharmacist | 1000 S Columbia Rd, Grand Forks, ND 58201-4032 | 2014-12-05 |
| Find all providers in the same location | ||||
| 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 | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306836937 | Elizabeth Ann Tyree | Physician Assistant | 5th Avenue North and Harvard Streets, Grand Forks, ND 58202 | 2005-10-25 |
| 1215474762 | James Hodges | Physician Assistant | 1451 44th Ave S, Grand Forks, ND 58201-3434 | 2017-01-23 |
| 1083074173 | Monica A. Lamm | Physician Assistant | 1200 S Columbia Rd - Altru Hospital, Grand Forks, ND 58201 | 2016-03-02 |
| 1770968232 | Kayla L Olson | Physician Assistant | 1300 S Columbia Rd, Grand Forks, ND 58201 | 2015-07-27 |
| 1942227939 | Tamra Sue Bauduin | Physician Assistant | 1300 S Columbia Rd, Grand Forks, ND 58201 | 2006-07-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891355608 | Jenny L Brown | Physician Assistant | 3750 19th St Sw, Center, ND 58530-9700 | 2019-06-14 |
| 1407335383 | Chelsey Galipeau | Physician Assistant | 516 1st Ave Sw, Dickinson, ND 58601-5906 | 2018-08-10 |
| 1093184657 | Grant Lannoye | Physician Assistant | 7448 Us Hwy 281, Cando, ND 58324-0688 | 2015-09-24 |
| 1821408907 | Laramie Jay Richmond | Physician Assistant | 311 Davis St N, Burlington, ND 58722-2027 | 2014-04-29 |
| 1962749226 | Lindsey K Baker | Physician Assistant | 1600 2nd Ave Sw Ste 19, Minot, ND 58701-3459 | 2013-01-07 |
| 1205015633 | Jamie M Brown | Physician Assistant | 1711 Gold Dr S, Suite 170, Fargo, ND 58103-6416 | 2007-11-02 |
| 1811036247 | Tyesha Dawn Marie Dent | Physician Assistant | 302 North Main, Elgin, ND 58533 | 2007-02-05 |
| 1629160080 | Teresa Nielsen | Physician Assistant | 820 2nd Ave W, New England, ND 58647 | 2006-09-29 |
| 1841208394 | Lynette Marie Azure | Physician Assistant | 320 4th St Se, Devils Lake, ND 58301-3610 | 2006-08-03 |
| 1790703353 | Mary Jane Kadry | Physician Assistant | 1121 Westrac Dr S Ste 204, Fargo, ND 58103-2385 | 2006-07-18 |
| Find all providers with the same taxonomy | ||||
| City | GRAND FORKS |
| Zip Code | 58201 |
Please comment or provide details below to improve the information on SUSAN J DVORAK.
| 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.