Kent R Hoerauf, MD
Individual provider Active NPI Internal Medicine Physician · Hettinger, ND
NPI 1104912849 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1104912849
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 4742 (ND)
- Practice address
- 1000 Highway 12
Hettinger, ND 58639-7530 - Phone
- (701) 567-4561
- NPI assigned
- Oct 4, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4742 | ND | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frances Mahon Deaconess Hospital | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 4742 | ND | Yes |
Addresses
Primary practice location
1000 Highway 12
Hettinger, ND 58639-7530
Mailing address
1100 Highway 12
Hettinger, ND 58639-7533
Phone (701) 567-6130
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10773 | Other | NC | ND BC/BS |
| 4999829 | Other | WELLMARCK OF SD | |
| 3018140 | Medicaid | WA | |
| 30786 | Other | SIOUX VALLEY | |
| 45034068812 | Medicaid | NE | |
| 94433 | Other | BLUE CROSS OTHER | |
| 7776130 | Medicaid | SD | |
| 123993 | Other | ND | WORKER'S COMP |
| 14678 | Medicaid | ND |
Other providers in Hettinger, ND
- Suzan Jean Hanson
- Lynly J Hebert
- Jacquelyn Ann Hedstrom
- Helen Andrea Henley
- Hettinger Family Dental, P.C.
- Rebecca Howe
- Courtney Hulm
- Thomas E Jacobsen
- Kali Jacobson
- John P Joyce
All providers in Hettinger, ND · Internal Medicine Physician in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.