Mark J Christenson, M.D.
Individual provider Active NPI Family Medicine Physician · Grand Forks, ND
NPI 1093774499 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1093774499
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 7337 (ND)
- Practice address
- McCannel Hall Room 100
2891 2ND Avenue North Stop 9038
Grand Forks, ND 58202-9038 - Phone
- (701) 777-4500
- Fax
- (701) 777-4835
- NPI assigned
- Mar 23, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ND
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140602001905 | ND | Practitioner - Family Practice | 7315024940 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7337 | ND | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University North Dakota | Current |
Accepting new patients | |
| University of North Dakota | Family Medicine | Current | Accepting new patients |
| University of North Dakota | Current |
Accepting new patients |
Locations
100 W Hall
#2
Grand Forks, ND 58202
Phone (701) 777-4500
2891 2nd Ave N
Stop 9038
Grand Forks, ND 58202
Phone (701) 777-4500
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 7337 | ND | Yes |
Addresses
Primary practice location
McCannel Hall Room 100
2891 2ND Avenue North Stop 9038
Grand Forks, ND 58202-9038
Mailing address
McCannel Hall Room 100
2891 2ND Avenue North Stop 9038
Grand Forks, ND 58202-9038
Phone (701) 777-4500
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10300 | Medicaid | ND |
Other providers in Grand Forks, ND
- Robert Scott Childs
- NA Yun Chine
- Chiro RX, LTD.
- Tiffany Chiu
- Megan J Christensen
- Meredith A. Christiansen
- Charles E. Christianson
- Anneetta Jean Christman
- Anthony G Chu
- Charles Champ Churchill
All providers in Grand Forks, ND · Family Medicine Physician in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.