Fargo Health, Inc.

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

FARGO HEALTH, INC.

Practice address

9325 Upland LN N
Suite 205
Maple Grove, MN 55369-4200

Phone

(612) 670-4971

NPI assigned

Oct 2, 2016

Organization subpart

No

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

Authorized official

Name

Mr. Robert Eric Hanson

Title

President

Phone

(612) 432-4131

Specialties & licenses 1

Addresses

Other names 1

• MN Spine Institute Doing business as

Locations

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

{
    "created_epoch": "1475366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515196800000",
    "number": "1053860056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 430",
            "city": "ISANTI",
            "state": "MN",
            "postal_code": "550400430",
            "telephone_number": "612-432-4131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9325 UPLAND LN N",
            "address_2": "SUITE 205",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553694200",
            "telephone_number": "612-670-4971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FARGO HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-02",
        "last_updated": "2018-01-06",
        "status": "A",
        "authorized_official_last_name": "HANSON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "ERIC",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "612-432-4131",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MN Spine Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Family Orthodontic Specialists, PLC
• Family Periodontic Specialists, PLC
• Ronda Farah, M.D.
• Safia Yasin Farah, M.A.
• Rachel Farber
• Jeffrey Fred Farran, PT
• Michael H Farrell, MD
• Sarah Kathryn Farthing I, NP-C
• Megan E Fasching, PA-C
• Joseph Faulds

• Specialist in Maple Grove, MN
• Providers in Maple Grove, MN by specialty
• Specialist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2018; 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.