NPIMap

Organization Active NPI

Pediatric Arts Clinic

  • Primary Care Clinic/Center
  • Fargo, ND
National Provider Identifier
1093937203
Registry record updated Jan 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
PEDIATRIC ARTS CLINIC
Practice address
3290 20TH St S Ste a
Fargo, ND 58104-5923
Phone
(701) 478-4722
Fax
(701) 893-9057
NPI assigned
May 3, 2007
Last updated
Jan 27, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2010

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

Authorized official

Name
Dr. Ender Raghib, M.D.NPI 1629155643
Title
President
Phone
(701) 478-4722

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X ND Primary

Addresses

Primary practice location

3290 20TH St S Ste a
Fargo, ND 58104-5923

Mailing address

3290 20TH St S Ste a
Fargo, ND 58104-5923
Phone (701) 478-4722

National Provider Directory

National Provider Directory

Locations

3290 20th St S
Ste A
Fargo, ND 58104
Phone (701) 478-4722

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264550400000",
    "number": "1093937203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3290 20TH ST S STE A",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581045923",
            "telephone_number": "701-478-4722",
            "fax_number": "701-893-9057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3290 20TH ST S STE A",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581045923",
            "telephone_number": "701-478-4722",
            "fax_number": "701-893-9057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC ARTS CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2010-01-27",
        "status": "A",
        "authorized_official_last_name": "RAGHIB",
        "authorized_official_first_name": "ENDER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "701-478-4722",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "ND",
            "license": null,
            "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 Jan 27, 2010; 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.