NPIMap

Individual provider Active NPI

David J Theige, MD

  • Internal Medicine Physician
  • Fargo, ND
National Provider Identifier
1245252816
Registry record updated Apr 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
5438 Issued in ND
Practice address
801 Broadway N
Fargo, ND 58102-3641
Phone
(701) 234-2731
Fax
(701) 234-2158
NPI assigned
Jul 24, 2006
Last updated
Apr 4, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 5438 ND Primary

Addresses

Primary practice location

801 Broadway N
Fargo, ND 58102-3641

Mailing address

801 Broadway N
Fargo, ND 58102-3641
Phone (701) 234-2731

Other identifiers 2

IdentifierTypeStateIssuer
823131100MedicaidMN
10011MedicaidND

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dtheige1841349@direct.sanfordhealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110726000288 ND Practitioner - HospitalistPractitioner - Internal Medicine 4385812924 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanford Medical Center FargoGroup PAC ID 8426967803, 1,210 clinicians

Practice addresses (Care Compare)

1220 Sheyenne St
West Fargo, ND 58078-2637
Phone (701) 234-4445

4840 23Rd Ave S
Fargo, ND 58104-9136
Phone (701) 417-6999

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Medical Center Fargo Internal Medicine CurrentSince Jul 1, 2011 Accepting new patients
Sanford Medical Center Fargo CurrentSince Jul 1, 2011 Accepting new patients

Locations

2400 32nd Ave S
Fargo, ND 58103
Phone (701) 234-8800

801 Broadway N
Fargo, ND 58102
Phone (701) 234-5121

1220 Sheyenne St
West Fargo, ND 58078
Phone (701) 234-4445

Interoperability endpoints

  • Direct secure messaging: dtheige1841349@direct.sanfordhealth.org

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.

Hospital & facility affiliations 5

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": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649030400000",
    "number": "1245252816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 BROADWAY N",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581023641",
            "telephone_number": "701-234-2731",
            "fax_number": "701-234-2158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 BROADWAY N",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581023641",
            "telephone_number": "701-234-2731",
            "fax_number": "701-234-2158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEIGE",
        "first_name": "DAVID",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2022-04-04",
        "certification_date": "2022-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ND",
            "license": "5438",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "823131100",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10011",
            "state": "ND"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dtheige1841349@direct.sanfordhealth.org",
            "affiliation": "N",
            "address_1": "801 Broadway N",
            "city": "Fargo",
            "state": "ND",
            "country_code": "US",
            "postal_code": "581023641",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.