DAVID J PENGILLY (NPI# 1710099114) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710099114 |
| Entity Type | Individual |
| Full Name | DAVID J PENGILLY |
| Credential | MD |
| Practice Address |
1040 Tacoma Avenue South Bismarck ND 58504 |
| Mailing Address |
Po Box 5501 Bismarck ND 58506-5501 |
| Practice Telephone | 7013236990 |
| Practice Fax Number | 7013236994 |
| Mailing Telephone | 7013236000 |
| Mailing Fax Number | 7013235709 |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2011-01-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 6620 | ND | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ND | 17617 | 05 |
| Street Address |
1040 TACOMA AVENUE SOUTH |
| City | BISMARCK |
| State | ND |
| Zip Code | 58504 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821196577 | Stuart T Smith | Family Medicine | 1040 Tacoma Avenue South, Bismarck, ND 58504 | 2006-09-20 |
| 1134227895 | Sherry L Stein | Family Medicine | 1040 Tacoma Avenue South, Bismarck, ND 58504 | 2006-09-20 |
| 1619089109 | Brenda L Miller | Family Medicine | 1040 Tacoma Avenue South, Bismarck, ND 58504 | 2006-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619578077 | Hit Inc. | Community/Behavioral Health | 1517/1519 S Washington St, Bismarck, ND 58504 | 2020-11-03 |
| 1518568963 | Hit Inc. | Community/Behavioral Health | 1509/1511 S Washington St., Bismarck, ND 58504 | 2020-11-03 |
| 1366926594 | Lisa Elizabeth Morgan | Counselor | 2600 Manchester St, Bismarck, ND 58504 | 2018-09-24 |
| 1528557006 | Mees Physical Therapy LLC | Physical Therapist | 109 Mcdougall Dr., Suite 4, Lincoln, ND 58504 | 2018-05-09 |
| 1437666856 | Katy Thomas | Social Worker | 3315 University Drive, Bismasrck, ND 58504 | 2018-01-08 |
| 1407396864 | Allison Bitz | Social Worker | 600 S. Second St., Suite 220, Bismarck, ND 58504 | 2017-03-06 |
| 1306397831 | Evan Morehead | Specialist/Technologist | 5160 Lincoln Road, Lincoln, ND 58504 | 2016-10-19 |
| 1902262520 | Stacey S Haugen, Pllc | Counselor | 6221 University Drive, Bismarck, ND 58504 | 2016-01-12 |
| 1881060630 | Brittany N Kudrna | Nurse Practitioner | 914 S 12th St Ste 101, Bismarck, ND 58504 | 2015-08-17 |
| 1154727873 | William J Kucera | Physical Therapist | 324 Marietta Dr, Bismarck, ND 58504 | 2014-11-06 |
| Find all providers in zip 58504 | ||||
| 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 |
|---|---|---|---|---|
| 1508241183 | Edith Wong | Family Medicine | 701 E Rosser Ave., Bismarck, ND 58501-4461 | 2015-07-24 |
| 1083942304 | Linda P Svec | Family Medicine | 2900 E Broadway Ave Ste 1, Bismarck, ND 58501-5184 | 2009-11-24 |
| 1891951992 | Natalia Brown | Family Medicine | 515 E. Broadway Ave., Bismarck, ND 58501-4491 | 2008-07-29 |
| 1457517542 | Joy Ann Froelich | Family Medicine | 4535 Northern Sky Drive, Bismarck, ND 58503 | 2008-07-29 |
| 1588826747 | Herbert J. Wilson | Family Medicine | 1244 W Coulee Rd, Bismarck, ND 58501-1245 | 2008-06-30 |
| 1629230081 | Ryan Clauson | Family Medicine | 2700 State St Ste 1, Bismarck, ND 58503-0669 | 2008-06-26 |
| 1073719399 | Jennifer Amber Beckwith | Family Medicine | 515 E Broadway Ave, Bismarck, ND 58501-4407 | 2007-06-24 |
| 1134251044 | Darren Duane Carter | Family Medicine | 411 N 4th St, Suite 5, Bismarck, ND 58501-4078 | 2007-03-09 |
| 1881739977 | Medcenter One Inc | Family Medicine | 1040 Tacoma Ave, Bismarck, ND 58504 | 2007-02-20 |
| 1326103920 | Medcenter One Inc | Family Medicine | 3318 N. 14th St, Bismarck, ND 58503 | 2006-12-26 |
| Find all providers in BISMARCK | ||||
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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.