Individual provider Active NPI

Darcy E Christianson, PA

  • Physician Assistant
  • Minot, ND
National Provider Identifier
1184720666
Registry record updated Oct 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PAC0155 Issued in ND
Practice address
1500-24TH Ave. S.W.
Minot, ND 58701-6905
Phone
(701) 857-5150
Fax
(701) 857-5564
NPI assigned
Sep 15, 2006
Last updated
Oct 20, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PAC0155 ND Primary
Physician Assistant 363A00000X 1402 MN
Physician Assistant 363A00000X 10736 MN

Addresses

Primary practice location

1500-24TH Ave. S.W.
Minot, ND 58701-6905

Mailing address

PO Box 5010
Minot, ND 58702-5010
Phone (701) 857-5650

Other identifiers 1

IdentifierTypeStateIssuer
P00937245OtherMNRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040315001145 ND Practitioner - Physician Assistant 7517856552 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1402MNMDChiropractor
10736MNMDFamily Nurse Practitioner

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445299200000",
    "number": "1184720666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5010",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587025010",
            "telephone_number": "701-857-5650",
            "fax_number": "701-857-5031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500-24TH AVE. S.W.",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587016905",
            "telephone_number": "701-857-5150",
            "fax_number": "701-857-5564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTIANSON",
        "first_name": "DARCY",
        "middle_name": "E",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-15",
        "last_updated": "2015-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ND",
            "license": "PAC0155",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "1402",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "10736",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00937245",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minot, ND

Sources for this page

Verify at the official NPI Registry.