Lillestol Research LLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

R30611 Issued in ND

Legal business name

LILLESTOL RESEARCH LLC

Practice address

1711 Gold Dr S
Suite 170
Fargo, ND 58103-6416

Phone

(701) 232-7705

Fax

(701) 893-9046

NPI assigned

Sep 12, 2011

Last updated

Sep 12, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Michael John Lillestol, MD

Title

President

Phone

(701) 232-7705

Specialties & licenses 1

Addresses

Locations

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.

• Jamie M Brown, PA-C

  • Medical Physician Assistant
  • Fargo, ND
  • NPI 1205015633
  NPD (past)

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

{
    "created_epoch": "1315785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315785600000",
    "number": "1104108695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1711 GOLD DR S",
            "address_2": "SUITE 170",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581036416",
            "telephone_number": "701-232-7705",
            "fax_number": "701-893-9046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1711 GOLD DR S",
            "address_2": "SUITE 170",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581036416",
            "telephone_number": "701-232-7705",
            "fax_number": "701-893-9046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LILLESTOL RESEARCH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-12",
        "last_updated": "2011-09-12",
        "status": "A",
        "authorized_official_last_name": "LILLESTOL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "701-232-7705",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ND",
            "license": "R30611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nurse Practitioner in Fargo, ND
• Providers in Fargo, ND by specialty
• Nurse Practitioner in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2011; 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.