NPIMap

Organization Active NPI

Rem North Dakota

  • Intellectual Disabilities Intermediate Care Facility
  • Minot, ND
National Provider Identifier
1104097740
Registry record updated Apr 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
License
000030841 Issued in ND
Legal business name
REM NORTH DAKOTA
Practice address
1905 2ND St SE Ste 1a
Minot, ND 58701-6566
Phone
(701) 418-2012
NPI assigned
Mar 21, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2023

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

Authorized official

Name
Brett Ian Cohen
Title
Coo
Phone
(800) 388-5150

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X 000030841 ND Primary

Addresses

Primary practice location

1905 2ND St SE Ste 1a
Minot, ND 58701-6566

Mailing address

1905 2ND St SE Ste 1a
Minot, ND 58701-6566
Phone (701) 418-2012

Other practice location 1

808 3rd Ave S
Suite 202
Fargo, ND 58103-1865
Phone (701) 237-0934

Other identifiers 1

IdentifierTypeStateIssuer
000030841MedicaidND

National Provider Directory

National Provider Directory
Tax ID family
Rem North Dakota20 organizations share this tax ID, including this one

Other organizations with this tax ID 19

Organizations that report the same tax identification number in the National Provider Directory.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1206057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682121600000",
    "number": "1104097740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 2ND ST SE STE 1A",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587016566",
            "telephone_number": "701-418-2012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 2ND ST SE STE 1A",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587016566",
            "telephone_number": "701-418-2012"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "808 3rd Ave S",
            "address_2": "Suite 202",
            "address_purpose": "LOCATION",
            "city": "Fargo",
            "state": "ND",
            "postal_code": "581031865",
            "country_code": "US",
            "telephone_number": "701-237-0934",
            "fax_number": "701-293-4041",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "REM NORTH DAKOTA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-21",
        "last_updated": "2023-04-22",
        "certification_date": "2023-04-22",
        "status": "A",
        "authorized_official_last_name": "COHEN",
        "authorized_official_first_name": "BRETT",
        "authorized_official_middle_name": "IAN",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "800-388-5150"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "ND",
            "license": "000030841",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000030841",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minot, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2023; 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.