NPIMap

Corinne A Dargus, PAC

Individual provider Active NPI Physician Assistant · Fosston, MN

NPI 1174559611 · NPPES record last updated Jul 13, 2026

Key facts

NPI
1174559611
Entity type
Individual (NPI type 1)
Primary specialty
Physician Assistant 363A00000X
License
8997 (MN)
Practice address
102 Sather Dr
Fosston, MN 56542-1531
Phone
(218) 435-1212
Fax
(218) 435-1302
NPI assigned
Jun 25, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

  • Alluma, Inc. Mental Health Clinic/Center (Including Community Mental Health Center) · Crookston, MN · NPI 1508835133
    NPD (past)

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
8997MNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Alluma, Inc. Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 8997 MN Yes

Addresses

Primary practice location

102 Sather Dr
Fosston, MN 56542-1531

Mailing address

PO Box 506
Fosston, MN 56542-0506
Phone (218) 435-1212

Other identifiers

IdentifierTypeStateIssuer
DA9071015605OtherMNPREFERRED ONE #
HP25733OtherMNHEALTHPARTNERS #
0111355OtherMNMEDICA #
18689OtherMNNDBS #
4F107DAOtherMNMNBS #
974761OtherMNAMERICA'S PPO/ARAZ #
142331OtherMNUCARE #

Other providers in Fosston, MN

All providers in Fosston, MN · Physician Assistant in Minnesota

Sources for this page

Verify at the official NPI Registry.