JESSICA ADELINE SATROM (NPI# 1669939658) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669939658 |
| Entity Type | Individual |
| Full Name | JESSICA ADELINE SATROM |
| Credential | P.A-C |
| Practice Address |
4656 40th Ave S Fargo ND 58104-4397 |
| Mailing Address |
2258 Thorndale Ave New Brighton MN 55112-5213 |
| Practice Telephone | 7012348860 |
| Practice Fax Number | 7012348924 |
| Mailing Telephone | 7017999444 |
| Enumeration Date | 2019-02-26 |
| Last Update Date | 2019-07-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 12706 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4656 40TH AVE S |
| City | FARGO |
| State | ND |
| Zip Code | 58104-4397 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639121304 | Thomas J Matzke | Dermatology | 4656 40th Ave S, Fargo, ND 58104-4397 | 2006-05-17 |
| 1528595790 | Brianna Lynn Strube | Physician Assistant | 4656 40th Ave S, Fargo, ND 58104-4397 | 2017-05-17 |
| 1225440324 | Ryan Bogner | Dermatology | 4656 40th Ave S, Fargo, ND 58104-4397 | 2014-05-22 |
| 1952641987 | Palak Patel | Physician Assistant | 4656 40th Ave S, Fargo, ND 58104 | 2013-02-28 |
| 1518247816 | Sanford Medical Center Fargo | Dermatology | 4656 40th Ave S, Fargo, ND 58104-4397 | 2011-08-18 |
| 1972895803 | Stephanie M Murphy | Physician Assistant | 4656 40th Ave S, Fargo, ND 58104-4397 | 2011-05-11 |
| 1952539223 | Tania Marie Gonzalez Santiago | Dermatology | 4656 40th Ave S, Fargo, ND 58104-4397 | 2009-06-25 |
| 1689836975 | Meritcare Medical Group | Dermatology | 4656 40th Ave S, Fargo, ND 58104-4394 | 2008-06-27 |
| 1609040427 | Joanne Ruth Montgomery | Dermatology | 4656 40th Ave S, Fargo, ND 58104-4397 | 2008-04-14 |
| 1932126919 | Judith L Reese | Dermatology | 4656 40th Ave S, Fargo, ND 58104-4397 | 2006-07-16 |
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| 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 |
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| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033665310 | Caitlyn R Cameron | Physician Assistant | 4110 51st Ave South, Fargo, ND 58104 | 2016-08-28 |
| 1295069664 | Megan Jean Boose | Physician Assistant | 3173 43rd St S Ste A, Fargo, ND 58104-4564 | 2009-10-01 |
| 1487715405 | Nancy M Eastman | Physician Assistant | 4622 40th Ave S, Fargo, ND 58104-4394 | 2006-12-13 |
| 1700826369 | Jeanne Waalen | Physician Assistant | 4200 Woodhaven St Sw, Fargo, ND 58104-3946 | 2006-06-08 |
| 1982642773 | Linda K Regan | Physician Assistant | 1800 21st Avenue South, Fargo, ND 58103 | 2006-06-03 |
| 1437153905 | Jay R Metzger | Physician Assistant | 306 4th St N, Fargo, ND 58102-4820 | 2005-06-13 |
| 1538786728 | Peter V Tronset | Physician Assistant | 5225 23rd Ave S, Fargo, ND 58104-7927 | 2020-07-03 |
| 1750908455 | Jordan Ann Wiedmann | Physician Assistant | 3201 33rd St S, Fargo, ND 58104-8823 | 2020-06-29 |
| 1144842089 | Matthew Hockert | Physician Assistant | 700 1st Ave S, Fargo, ND 58103-1802 | 2020-05-14 |
| 1770110777 | Steffani Nicole Johnston Mack | Physician Assistant | 700 1st Ave S, Fargo, ND 58103-1802 | 2020-03-27 |
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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.