Vincent Adjetey, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

17144 Issued in ND

Practice address

709 4TH Ave NE
Watford City, ND 58854-7628

Phone

(701) 842-3771

Fax

(701) 842-6248

NPI assigned

Jun 27, 2018

Last updated

Dec 13, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ND, TX2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Children's Physician Services of South Texas

  dba Plastic Reconstructive Surgical Services of South Texas

  • Plastic Surgery Physician
  • Corpus Christi, TX
  • NPI 1568658227
  Medicare reassignment NPD
• Coastal Children's Clinic PA

  • Pediatrics Physician
  • Corpus Christi, TX
  • NPI 1164471116
  Medicare reassignment NPD
• Children's Physician Services of South Texas

  • Pediatrics Physician
  • Corpus Christi, TX
  • NPI 1801856786
  NPD

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

{
    "created_epoch": "1530057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639353600000",
    "number": "1093200420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 4TH AVE NE",
            "city": "WATFORD CITY",
            "state": "ND",
            "postal_code": "588547628",
            "telephone_number": "701-842-3771",
            "fax_number": "701-842-6248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 4TH AVE NE",
            "city": "WATFORD CITY",
            "state": "ND",
            "postal_code": "588547628",
            "telephone_number": "701-842-3771",
            "fax_number": "701-842-6248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADJETEY",
        "first_name": "VINCENT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-27",
        "last_updated": "2021-12-13",
        "certification_date": "2021-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "ND",
            "license": "17144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• 5H, LLC
• Ashley Abbe
• Jennifer Abraham
• Valarie Alexander, CNA
• Aligned Family Chiropractic
• Julia Allen, DMD
• Anova Family Health Center Inc.
• Kendra Bohm

• Pediatrics Physician in Watford City, ND
• Providers in Watford City, ND by specialty
• Pediatrics Physician in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2021; 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.

Verify at the official NPI Registry.