Digestive Endoscopy, PA

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

19698 Issued in MN

Legal business name

DIGESTIVE ENDOSCOPY, PA

Practice address

17322 91St Ave N
Maple Grove, MN 55311-5403

Phone

(763) 416-0399

Fax

(763) 416-0399

NPI assigned

May 2, 2012

Organization subpart

No

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

Authorized official

Name

Mr. William Charles Duane Jr., MD

Title

President

Phone

(763) 416-0399

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• James Peter Kromhout, M.D.

  • Gastroenterology Physician
  • Buffalo, MN
  • NPI 1720098932
  NPD (past)

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

{
    "created_epoch": "1335916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335916800000",
    "number": "1144588773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5970 ARBOUR AVE",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554362521",
            "telephone_number": "952-920-6638",
            "fax_number": "612-725-2248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17322 91ST AVE N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553115403",
            "telephone_number": "763-416-0399",
            "fax_number": "763-416-0399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIGESTIVE ENDOSCOPY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-02",
        "last_updated": "2012-05-02",
        "status": "A",
        "authorized_official_last_name": "DUANE",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "763-416-0399",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MN",
            "license": "19698",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "255716900",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI 1",
            "identifier": "1033127964",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thaily Diaz Fleites, DDS
• Marie A Diaz Varona, PSYD, LP
• Catherine Didur
• Bridgett Ann Diers, PT, DPT, ATC
• Michael V Dieter, O.D.
• Emma Nicole Dilks Kuchera
• Bethany R Dillon, MA, LPCC, CCTP
• Distinctive Eyewear, LLC (Northwest Eyewear)
• Diversey Home Care, LLC
• Divine Nurturing Homecare Services, Inc.

• Gastroenterology Physician in Maple Grove, MN
• Providers in Maple Grove, MN by specialty
• Gastroenterology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2012; 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.