Organization Active NPI

Winmar Diagnostics North Central, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Fargo, ND
National Provider Identifier
1114071040
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
WINMAR DIAGNOSTICS NORTH CENTRAL, INC.
Practice address
2700 12TH Ave S
Ste B
Fargo, ND 58103-8723
Phone
(701) 235-7424
Fax
(701) 239-4792
NPI assigned
Jan 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Marcia Ann Nelson
Title
Ceo
Phone
(701) 235-7424

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

2700 12TH Ave S
Ste B
Fargo, ND 58103-8723

Mailing address

2700 12TH Ave S
Ste B
Fargo, ND 58103-8723
Phone (701) 235-7424

Other identifiers 2

IdentifierTypeStateIssuer
889613500MedicaidMN
50084MedicaidND

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930082017 ND DME Supplier - Medical Supply Company With Respiratory TherapistDME Supplier - Oxygen & Equipment 4880695568 Practice locations: Fargo, ND

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Winmar Diagnostics2700 12TH Ave S, Fargo, ND 58103-8723(701) 235-7424 Continuous Positive Airway Pressure (CPAP) Devices|Respiratory Assist Devices Accepts assignmentParticipating since Jan 1, 1998

National Provider Directory

National Provider Directory
Tax ID family
Winmar Diagnostics Nort4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

2700 12th Ave SW
Ste B
Fargo, ND 58103
Phone (701) 235-7424

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1114071040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 12TH AVE S",
            "address_2": "STE B",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581038723",
            "telephone_number": "701-235-7424",
            "fax_number": "701-239-4792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 12TH AVE S",
            "address_2": "STE B",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581038723",
            "telephone_number": "701-235-7424",
            "fax_number": "701-239-4792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINMAR DIAGNOSTICS NORTH CENTRAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-22",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "MARCIA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "701-235-7424"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "889613500",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "50084",
            "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 Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.