Individual provider Active NPI

Dianne Aletha Goebel, RT

  • Radiography Radiologic Technologist
  • Fort Totten, ND
National Provider Identifier
1053594093
Registry record updated Dec 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiography Radiologic TechnologistTaxonomy code 2471C3402X
License
081694 Issued in ND
Practice address
3883 74TH Avenue North East
Ft Totten, ND 58335
Phone
(701) 766-1629
NPI assigned
Dec 13, 2007
Last updated
Dec 13, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiography Radiologic Technologist 2471C3402X 081694 ND Primary

Addresses

Primary practice location

3883 74TH Avenue North East
Ft Totten, ND 58335

Mailing address

3883 74TH Avenue North East
Fort Totten, ND 58335-0309
Phone (701) 766-1629

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
081694NDMDRadiography Radiologic Technologist

NPI Registry JSON

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

{
    "created_epoch": "1197504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197504000000",
    "number": "1053594093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3883 74TH AVENUE NORTH EAST",
            "city": "FORT TOTTEN",
            "state": "ND",
            "postal_code": "583350309",
            "telephone_number": "701-766-1629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3883 74TH AVENUE NORTH EAST",
            "city": "FT TOTTEN",
            "state": "ND",
            "postal_code": "58335",
            "telephone_number": "701-766-1629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOEBEL",
        "first_name": "DIANNE",
        "middle_name": "ALETHA",
        "name_prefix": "Ms.",
        "credential": "RT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-13",
        "last_updated": "2007-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2471C3402X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Radiography",
            "state": "ND",
            "license": "081694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Totten, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2007; 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.