Active NPI
Nicholas Scott-Wittenborn, MD
- Otolaryngology Physician
- Fargo, ND
National Provider Identifier
1053817825
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- PT24661
- Practice address
- 801 Broadway N
Fargo, ND 58102-3641 - Phone
- (701) 234-2000
- NPI assigned
- Apr 2, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 45380 | OK | |
| Otolaryngology Physician | 207Y00000X | PT24661 | ND | Primary |
Addresses
Primary practice location
801 Broadway N
Fargo, ND 58102-3641
Mailing address
PO Box 5074
Sioux Falls, SD 57117-5074
Phone (605) 328-9419
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180725000241 | MD | Order and Referring Only - Otolaryngology | 2062769813 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 45380 | OK | MD | Otolaryngology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1522627200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1785369600000",
"number": "1053817825",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5074",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "571175074",
"telephone_number": "605-328-9419"
},
{
"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": "701-234-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCOTT-WITTENBORN",
"first_name": "NICHOLAS",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-04-02",
"last_updated": "2026-07-30",
"certification_date": "2026-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "OK",
"license": "45380",
"primary": false
},
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "ND",
"license": "PT24661",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fargo, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.