Mary Isom (NPI# 1336599083, PAC ID# 3375839434) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1336599083 |
| PAC ID by PECOS | 3375839434 |
| Professional Enrollment ID | I20160915002316 |
| Full Name | Mary Isom |
| Organization Legal Name | SANFORD CLINIC NORTH |
| Address |
21 Wiley Ave S Lidgerwood ND 58053-4001 |
| Phone Number | 7015384189 |
| Gender | F |
| Graduation Year | 2015 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 4284546151 |
| Number of Group Practice Members | 369 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 241377 | ST FRANCIS MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 2400 32nd Ave S, Fargo, ND 58103-5800 | SANFORD CLINIC NORTH | |
| 21 Wiley Ave S, Lidgerwood, ND 58053-4001 | 7015384189 | SANFORD CLINIC NORTH |
| 332 2nd Ave N, Wahpeton, ND 58075-4528 | 7016427000 | SANFORD CLINIC NORTH |
| Organization Legal Name | SANFORD CLINIC NORTH |
| Physicians | 392 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Sadie M Nelson | Nurse Practitioner | Sanford Clinic North | 801 Broadway N, Fargo, ND 58102-3641 |
| Jenna M Long | Nurse Practitioner | Sanford Clinic North | 100 St Ave Sw, Suite 2, Lamoure, ND 58458-7419 |
| Tamera A Ostenaa | Nurse Practitioner | Sanford Clinic North | 410 4th St Nw, Mahnomen, MN 56557-4208 |
| Daniel M Hoffman | Dermatology | Sanford Clinic North | 4656 40th Ave S, Fargo, ND 58104-4397 |
| Morgan R Rinke | Nurse Practitioner | Sanford Clinic North | 820 4th St N, Fargo, ND 58102-4539 |
| Mridu Gandhi | Family Medicine | Sanford Clinic North | 929 Central Ave Nw, East Grand Forks, MN 56721-1917 |
| Ashish V Regulagadda | Nephrology | Sanford Clinic North | 736 Broadway N, Fargo, ND 58122-4421 |
| Mackenze J Cimbura | Physical Therapy | Sanford Clinic North | 904 5th Ave Ne, Jamestown, ND 58401-3437 |
| Carrie L Holt | Nurse Practitioner | Sanford Clinic North | 108 Viking Ave W, Ulen, MN 56585-0024 |
| Tara R Mertz-hack | Family Medicine | Sanford Clinic North | 420 S 7th St, Oakes, ND 58474-2024 |
| Street Address |
21 WILEY AVE S |
| City | LIDGERWOOD |
| State | ND |
| Zip | 58053-4001 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Bruce T Amundson | Physical Therapy | Sanford Clinic North | 21 Wiley Ave S, Lidgerwood, ND 58053-4001 |
| Lisa R Braun | Physician Assistant | Sanford Clinic North | 21 Wiley Ave S, Lidgerwood, ND 58053-4001 |
| Caroline Wangui | Nurse Practitioner | Sanford Clinic North | 21 Wiley Ave S, Lidgerwood, ND 58053-4001 |
| Jeffrey S Hedlund | Physician Assistant | Sanford Clinic North | 21 Wiley Ave S, Lidgerwood, ND 58053-4001 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Breanna N Bischoff | Chiropractic | 22 Wiley Ave, Lidgerwood, ND 58053-0086 |
| City | LIDGERWOOD |
| Zip Code | 58053 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | LIDGERWOOD + PHYSICIAN ASSISTANT |
Please comment or provide details below to improve the information on Mary Isom.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.