FARGO VAMC (NPI# 1578514154) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578514154 |
| Entity Type | Organization |
| Organization Name | FARGO VAMC |
| Other Organization Name | BISMARCK VA CBOC |
| Practice Address |
2700 State St Gateway Mall Bismarck ND 58503-0669 |
| Mailing Address |
Po Box 94452 Cleveland OH 44101-4452 |
| Practice Telephone | 9135784409 |
| Mailing Telephone | 9135784409 |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2017-11-30 |
| Authorized Official Name | ERIN POTTER (NPI TEAM MEMBER) |
| Authorized Official Telephone | 2023822579 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QV0200X |
Clinic/Center Specialization: VA |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Bismarck VA CBOC | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194358739 | Fargo Vamc | Clinic/Center | 721 1st Ave N, Fargo, ND 58102-4903 | 2020-02-21 |
| 1851796072 | Fargo Vamc | Clinic/Center | 1031 7th Street Northeast, Devils Lake, ND 58301-5830 | 2014-10-30 |
| 1023426913 | Fargo Vamc | Clinic/Center | 766 Elks Dr Ste 6h, Dickinson, ND 58601-2915 | 2014-07-24 |
| 1346437944 | Fargo Vamc | Clinic/Center | 1217 Anne St Nw, Bemidji, MN 56601-5113 | 2007-09-27 |
| 1598952194 | Fargo Vamc | Clinic/Center | 1542 16th St W Ste 300, Williston, ND 58801-3888 | 2007-09-27 |
| 1528006574 | Fargo Vamc | Clinic/Center | 3400 S Broadway, Minot, ND 58701-7420 | 2006-06-03 |
| 1457306813 | Fargo Vamc | Clinic/Center | 1319 West 11th Street, Grafton, ND 58237-2138 | 2006-05-24 |
| 1407809478 | Fargo Vamc | Clinic/Center | 1821 N Park St, Fergus Falls Va Outpatient Clinic, Fergus Falls, MN 56537-1247 | 2006-05-18 |
| 1225445463 | Fargo Vamc | Clinic/Center | 2430 20th St Sw, Suite 8, Jamestown, ND 58401-6201 | 2014-07-21 |
| 1811220742 | Fargo Vamc | Clinic/Center | 3221 32nd Ave S, Suite 700, Grand Forks, ND 58201-6071 | 2009-09-10 |
| Street Address |
2700 STATE ST GATEWAY MALL |
| City | BISMARCK |
| State | ND |
| Zip Code | 58503-0669 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023649860 | Kayla Cofer | Nurse Practitioner | 2700 State St, Bismarck, ND 58503-0669 | 2020-01-30 |
| 1033515788 | Alexis Bullinger | Physical Therapist | 2700 State St, Bismarck, ND 58503-0669 | 2014-11-07 |
| 1154666006 | Preston Schaffner | Physician Assistant | 2700 State St, Bismarck, ND 58503-0669 | 2012-12-04 |
| 1568616670 | Carmen Repnow | Occupational Therapist | 2700 State St, Suite 1, Bismarck, ND 58503-0669 | 2008-11-17 |
| 1326291238 | Heritage Pharmacy Gateway Mall Inc | Pharmacy | 2700 State St, Ste F13, Bismarck, ND 58503-0669 | 2008-10-23 |
| 1548433493 | Hear Again Inc | Durable Medical Equipment & Medical Supplies | 2700 State St, Bismarck, ND 58503-0669 | 2008-04-10 |
| 1346428703 | Jason Shillingstad | Hearing Instrument Specialist | 2700 State St, Bismarck, ND 58503-0669 | 2008-02-07 |
| 1184801045 | Jessica Ann Lervick | Physical Therapist | 2700 State St, Bismarck, ND 58503-0669 | 2008-01-23 |
| 1588737274 | Debra Kaye Orley | Pharmacist | 2700 State St, Bismarck Veterans Clinic, Bismarck, ND 58503-0669 | 2006-11-17 |
| 1922116839 | Patricia Louise Gereszek | Nurse Practitioner | 2700 State St, Bismarck, ND 58503-0669 | 2006-08-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356951503 | Community Options for Residential and Employment Services, Inc | Community/Behavioral Health | 4909 Shelburne St, Bismarck, ND 58503 | 2020-08-03 |
| 1104460476 | Brittany Lee Feil | Registered Nurse | 808 N Washington St., Bismarck, ND 58503 | 2019-10-30 |
| 1760030670 | Rachel Lees | Technician | 1727 Valley Drive, Bismark, ND 58503 | 2019-09-04 |
| 1700444619 | St Alexius Medical Center | Non-Pharmacy Dispensing Site | 807 East Main Suite A, Bismarck, ND 58503 | 2019-06-05 |
| 1881162972 | White Drug Co of Jamestown Inc | Pharmacy | 900 Ne 43rd Ave, Bismarck, ND 58503 | 2018-11-06 |
| 1104347137 | Adapt, Inc. | Counselor | 1720 Burnt Boat Drive, Suite 108, Bismarck, ND 58503 | 2017-06-29 |
| 1679010953 | Optimum Therapies of North Dakota, Inc | Physical Therapist | 4204 Boulder Ridge Rd, Suite 100, Bismarck, ND 58503 | 2017-01-25 |
| 1972954162 | Ava Burckhard | Speech-Language Pathologist | 4501 Coleman St N Suite #103, Pediatric Therapy Partners, Bismarck, ND 58503 | 2016-06-29 |
| 1306292842 | Margaret Williams | Nurse Practitioner | 4315 Ottawa St, Bismarck, ND 58503 | 2016-05-13 |
| 1649638958 | Horizon Chiropractic & Wellness PC | Chiropractor | 4535 Northern Sky Dr., Bismarck, ND 58503 | 2016-02-01 |
| Find all providers in zip 58503 | ||||
| Taxonomy Code | 261QV0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | VA |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194358739 | Fargo Vamc | Clinic/Center | 721 1st Ave N, Fargo, ND 58102-4903 | 2020-02-21 |
| 1851796072 | Fargo Vamc | Clinic/Center | 1031 7th Street Northeast, Devils Lake, ND 58301-5830 | 2014-10-30 |
| 1023426913 | Fargo Vamc | Clinic/Center | 766 Elks Dr Ste 6h, Dickinson, ND 58601-2915 | 2014-07-24 |
| 1598952194 | Fargo Vamc | Clinic/Center | 1542 16th St W Ste 300, Williston, ND 58801-3888 | 2007-09-27 |
| 1528006574 | Fargo Vamc | Clinic/Center | 3400 S Broadway, Minot, ND 58701-7420 | 2006-06-03 |
| 1457306813 | Fargo Vamc | Clinic/Center | 1319 West 11th Street, Grafton, ND 58237-2138 | 2006-05-24 |
| 1225445463 | Fargo Vamc | Clinic/Center | 2430 20th St Sw, Suite 8, Jamestown, ND 58401-6201 | 2014-07-21 |
| 1811220742 | Fargo Vamc | Clinic/Center | 3221 32nd Ave S, Suite 700, Grand Forks, ND 58201-6071 | 2009-09-10 |
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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.