Active NPI
Nina Magdalena Robinson
- Sports Medicine (Physical Medicine & Rehabilitation) Physician
- Fargo, ND
National Provider Identifier
1104390764
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Medicine (Physical Medicine & Rehabilitation) Physician
- License
- 2633715
- Practice address
- 1301 Centennial Blvd
Fargo, ND 58102 - Phone
- (612) 708-7434
- NPI assigned
- Jan 17, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Medicine (Physical Medicine & Rehabilitation) Physician | 2081S0010X | 2633715 | ND | Primary |
Addresses
Primary practice location
1301 Centennial Blvd
Fargo, ND 58102
Mailing address
1837 University Dr N
Fargo, ND 58105-2504
Phone (612) 708-7434
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2633715 | Medicaid | ND |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2633715 | ND | MD | Sports Medicine (Physical Medicine & Rehabilitation) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1547683200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1547683200000",
"number": "1104390764",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1837 UNIVERSITY DR N",
"city": "FARGO",
"state": "ND",
"postal_code": "581052504",
"telephone_number": "612-708-7434"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1301 CENTENNIAL BLVD",
"city": "FARGO",
"state": "ND",
"postal_code": "58102",
"telephone_number": "612-708-7434"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBINSON",
"first_name": "NINA",
"middle_name": "MAGDALENA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-01-17",
"last_updated": "2019-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "2081S0010X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation, Sports Medicine",
"state": "ND",
"license": "2633715",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2633715",
"state": "ND"
}
],
"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 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.