DOUGLAS M GRIFFIN (NPI# 1700856911) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700856911 |
| Entity Type | Individual |
| Full Name | DOUGLAS M GRIFFIN |
| Credential | MD |
| Practice Address |
736 Broadway N Fargo ND 58102-4421 |
| Practice Telephone | 7012346160 |
| Mailing Telephone | 7012346160 |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2018-11-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | 31087 | MN | Allopathic & Osteopathic Physicians |
| Y | 207Q00000X | Family Medicine | 13899 | ND | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | AMERICA'S PPO | 595969 | 01 |
| MN | MEDICA | 0103802 | 01 |
| MN | 451595100 | 05 | |
| MN | CHAMPUS | A013 | 01 |
| MN | UCARE | 114455D277 | 01 |
| MN | BLUE SHIELD | 53Q29GR | 01 |
| MN | HEALTH PARTNERS | HP21657 | 01 |
| MN | PREFERRED ONE | 01011082 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1527 Broadway St, Alexandria, MN 563082537 | 3207620399 | 3207626847 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134743750 | Douglas Spencer Griffin | Counselor | 1715 Deer Tracks Trl Ste 260, Saint Louis, MO 63131-1855 | 2020-05-29 |
| 1538440276 | Douglas Mitchel Griffin | Pharmacist | 7350 Barrington Rd, Hanover Park, IL 60133-3301 | 2011-09-08 |
| 1366525172 | Douglas Alan Griffin | Dentist | 200 N Phoenix Ave, Russellville, AR 72801-2826 | 2006-10-23 |
| 1710994876 | Douglas Griffin | Specialist | 801 Merrick Ave, East Meadow, NY 11554-4748 | 2006-08-02 |
| 1215923750 | Douglas Griffin | Podiatrist | 6116 E. Arbor Ave, Suite 118, Mesa, AZ 85206-5235 | 2005-09-20 |
| Street Address |
736 BROADWAY N |
| City | FARGO |
| State | ND |
| Zip Code | 58102-4421 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528666914 | Brett Brockpahler | Physical Therapist | 736 Broadway N, Fargo, ND 58102-4421 | 2020-10-16 |
| 1235756040 | Ramneet Kaur Singh | Family Medicine | 736 Broadway N, Fargo, ND 58102-4421 | 2020-06-26 |
| 1467002733 | Cassandra Nicole Flach | Physical Therapist | 736 Broadway N, Fargo, ND 58102-4421 | 2019-09-18 |
| 1710548862 | Jeremiah Johnson | Nurse Practitioner | 736 Broadway N, Fargo, ND 58102-4421 | 2019-06-27 |
| 1659932580 | Randy W Johnson | Nurse Practitioner | 736 Broadway N, Fargo, ND 58102-4421 | 2019-06-21 |
| 1427618800 | Alison Lynn Kopp | Physical Therapist | 736 Broadway N, Fargo, ND 58102-4421 | 2019-06-18 |
| 1952867178 | Heather Crystal Carkhuff | Physician Assistant | 736 Broadway N, Fargo, ND 58102-4421 | 2019-02-12 |
| 1790256329 | Danielle Jo Matta | Nurse Practitioner | 736 Broadway N, Fargo, ND 58102-4421 | 2018-12-07 |
| 1013483692 | Tamera Ostenaa | Family Medicine | 736 Broadway N, Fargo, ND 58122-4732 | 2018-10-22 |
| 1952877862 | Kari Ann Solberg | Family Medicine | 736 Broadway N, Fargo, ND 58102 | 2018-10-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780285924 | Shelley Dene Townsend-hansen | Dentist | 1017 Broadway N, Fargo, ND 58102 | 2020-11-04 |
| 1275190779 | Anthony Joseph Duncan | Student in an Organized Health Care Education/Training Program | 1919 Elm Streent North, Fargo, ND 58102 | 2019-05-21 |
| 1003472317 | Sadie Marie Nelson | Nurse Practitioner | Sanford Broadway Clinic, 801 North Broadway, Fargo, ND 58102 | 2019-05-13 |
| 1124523576 | Christopher Peroutka | Specialist/Technologist | 1300 17th Ave N, Fargo, ND 58102 | 2018-03-28 |
| 1205331873 | Nathan Koens | Specialist/Technologist | 1300 17th Avenue North, Fargo, ND 58102 | 2018-03-27 |
| 1376063370 | Abby Nicole Fredrickson | Student in an Organized Health Care Education/Training Program | 1919 Elm Street North, Fargo, ND 58102 | 2017-06-21 |
| 1780118331 | Stephanie Melquist | Internal Medicine | Internal Medicine Resident Clinic, 801 N Broadway, Fargo, ND 58102 | 2017-04-19 |
| 1104215623 | Justin Lervik | Social Worker | 211 Elm St. N, 122, Fargo, ND 58102 | 2015-01-21 |
| 1770919441 | Courtney Ann Simanski | Speech-Language Pathologist | 415 4th St. N., Fargo, ND 58102 | 2013-09-25 |
| 1821431206 | Lanell Staroba | Pharmacist | 706 D 38th St, Fargo, ND 58102 | 2013-04-16 |
| Find all providers in zip 58102 | ||||
| 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 |
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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.