Individual provider Active NPI

Stephen Theodore Linn, MD

  • Obstetrics & Gynecology Physician
  • Fargo, ND
National Provider Identifier
1235216862
Registry record updated Mar 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
12092 Issued in ND
Practice address
3000 32ND Ave S
Fargo, ND 58103-6132
Phone
(701) 364-8900
NPI assigned
Nov 1, 2006
Last updated
Mar 27, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 12092 ND Primary

Addresses

Primary practice location

3000 32ND Ave S
Fargo, ND 58103-6132

Mailing address

400 E 3Rd St
Duluth, MN 55805-1951
Phone (701) 364-8900

Other identifiers 3

IdentifierTypeStateIssuer
16459MedicaidND
412776MedicaidAZ
AZ0775220OtherAZBCBS

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111111000463 ND Practitioner - Obstetrics/Gynecology 9032148218 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of North Dakota School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Innovis Health LLCGroup PAC ID 9931298155, 561 clinicians

Practice addresses (Care Compare)

3000 32ND Ave S
Fargo, ND 58103-6132
Phone (701) 364-8000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
12092NDMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Innovis Health, LLC. Family Medicine CurrentSince Nov 1, 2011 Accepting new patients
Innovis Health LLC Family Medicine CurrentSince Nov 1, 2011 Accepting new patients
Innovis Health, LLC Current Accepting new patients
Stephen T. Linn MD LLC Obstetrics & Gynecology PastSince Apr 18, 2005 Accepting new patients
District Medical Group, Inc Family Medicine Past Accepting new patients

Locations

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

3000 32nd Ave S
Fargo, ND 58103
Phone (701) 364-3000

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522108800000",
    "number": "1235216862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "701-364-8900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 32ND AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581036132",
            "telephone_number": "701-364-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINN",
        "first_name": "STEPHEN",
        "middle_name": "THEODORE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2018-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "ND",
            "license": "12092",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "16459",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "412776",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "AZ0775220",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.