Organization Active NPI

Steven C. Kourajian, O.D., P.C.

  • Optometrist
  • Harvey, ND
National Provider Identifier
1053591537
Registry record updated Jan 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
ND 408 Issued in ND
Legal business name
STEVEN C. KOURAJIAN, O.D., P.C.
Practice address
901 Lincoln Ave
Harvey, ND 58341-1523
Phone
(701) 324-2154
Fax
(701) 324-2160
NPI assigned
Nov 13, 2007
Last updated
Jan 18, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2008

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

Authorized official

Name
Dr. Steven Charles KourajianNPI 1255315792
Title
Optometrist
Phone
(701) 324-2154

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
Optometrist 152W00000X ND 408 ND Primary

Addresses

Primary practice location

901 Lincoln Ave
Harvey, ND 58341-1523

Mailing address

901 Lincoln Ave
Harvey, ND 58341-1523
Phone (701) 324-2154

Other identifiers 2

IdentifierTypeStateIssuer
01625001OtherNDBLUE CROSS BLUE SHIELD
60604MedicaidND

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040924000863 ND Part B Supplier - Clinic/Group Practice 2567431786 Receives reassigned benefits from 1 practitioner
Practice locations: Harvey, ND
O20100930066573 ND DME Supplier - Physician - Optometrist 2567431786 Practice locations: Harvey, ND

National Provider Directory

National Provider Directory

Locations

901 Lincoln Ave
Harvey, ND 58341
Phone (701) 324-2154

Practitioners & affiliated clinicians

Practitioners 1

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": "1194912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200614400000",
    "number": "1053591537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 LINCOLN AVE",
            "city": "HARVEY",
            "state": "ND",
            "postal_code": "583411523",
            "telephone_number": "701-324-2154",
            "fax_number": "701-324-2160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 LINCOLN AVE",
            "city": "HARVEY",
            "state": "ND",
            "postal_code": "583411523",
            "telephone_number": "701-324-2154",
            "fax_number": "701-324-2160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEVEN C. KOURAJIAN, O.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-13",
        "last_updated": "2008-01-18",
        "status": "A",
        "authorized_official_last_name": "KOURAJIAN",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "701-324-2154",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ND",
            "license": "ND 408",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "01625001",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60604",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harvey, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.