Organization Active NPI

Young Men's Christian Association of Grand Forks

  • Athletic Trainer
  • Grand Forks, ND
National Provider Identifier
1043851686
Registry record updated Jul 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
Legal business name
YOUNG MEN'S CHRISTIAN ASSOCIATION OF GRAND FORKS
Practice address
215 N 7TH St
Grand Forks, ND 58203-3668
Phone
(701) 775-2586
Fax
(701) 775-9611
NPI assigned
Oct 4, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2021

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

Authorized official

Name
Adam SorumNPI 1982276234
Title
Healthy Living Director
Phone
(701) 775-2586

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic TrainerGroup: 193400000X SINGLE SPECIALTY GROUP 2255A2300X Primary

Addresses

Primary practice location

215 N 7TH St
Grand Forks, ND 58203-3668

Mailing address

215 N 7TH St
Grand Forks, ND 58203-3668
Phone (701) 775-2586

Other names 1

  • YMCA Family Center Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1570147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626307200000",
    "number": "1043851686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 N 7TH ST",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582033668",
            "telephone_number": "701-775-2586",
            "fax_number": "701-775-9611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 N 7TH ST",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582033668",
            "telephone_number": "701-775-2586",
            "fax_number": "701-775-9611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUNG MEN'S CHRISTIAN ASSOCIATION OF GRAND FORKS",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-04",
        "last_updated": "2021-07-15",
        "certification_date": "2021-07-15",
        "status": "A",
        "authorized_official_last_name": "SORUM",
        "authorized_official_first_name": "ADAM",
        "authorized_official_title_or_position": "HEALTHY LIVING DIRECTOR",
        "authorized_official_telephone_number": "701-775-2586"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "YMCA Family Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Grand Forks, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2021; 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.