Waldemar G Storm, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

5336 Issued in ND

Practice address

801 Broadway N
Fargo, ND 58102-3641

Phone

(701) 234-2261

Fax

(701) 234-7194

NPI assigned

Jul 24, 2006

Last updated

May 2, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335916800000",
    "number": "1023030681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 BROADWAY N",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581023641",
            "telephone_number": "701-234-2261",
            "fax_number": "701-234-7194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 BROADWAY N",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581023641",
            "telephone_number": "701-234-2261",
            "fax_number": "701-234-7194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STORM",
        "first_name": "WALDEMAR",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2012-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "ND",
            "license": "5336",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "574782100",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "15303",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anna Stoppleworth
• Harrison F. Storandt, R.PH.
• Larae Marie Storer, APRN, FNP
• Alaina Elizabeth Storey
• Jade Storley, PA-C
• Bailey S Stotts, MOT, OTR/L
• Kaley M Stotz, PT, DPT
• Christopher Matthew Stout, RN
• Elizabeth Roze Stoutland, LMSW
• David Allen Stover, MD

• Pediatrics Physician in Fargo, ND
• Providers in Fargo, ND by specialty
• Pediatrics Physician in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.