Organization Active NPI

Dakota Clinic, LTD.

  • Family Medicine Physician
  • Detroit Lakes, MN
National Provider Identifier
1104877455
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
DAKOTA CLINIC, LTD.
Practice address
125 Frazee St E
Detroit Lakes, MN 56501-3501
Phone
(218) 844-2300
Fax
(218) 844-2444
NPI assigned
May 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Larry G Solberg
Title
Administrator-Authorized Official
Phone
(701) 364-3405

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

125 Frazee St E
Detroit Lakes, MN 56501-3501

Mailing address

PO Box 727
Detroit Lakes, MN 56502-0727
Phone (218) 844-2300

Other names 1

  • Dakota Clinic, Ltd. - Detroit Lakes Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104877455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 727",
            "city": "DETROIT LAKES",
            "state": "MN",
            "postal_code": "565020727",
            "telephone_number": "218-844-2300",
            "fax_number": "218-844-2444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 FRAZEE ST E",
            "city": "DETROIT LAKES",
            "state": "MN",
            "postal_code": "565013501",
            "telephone_number": "218-844-2300",
            "fax_number": "218-844-2444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAKOTA CLINIC, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SOLBERG",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "ADMINISTRATOR-AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "701-364-3405"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dakota Clinic, Ltd. - Detroit Lakes",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Detroit Lakes, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.