Organization Active NPI

Dakota Adult & Pediatric Psychiatry

  • Psychiatry Physician
  • Fargo, ND
National Provider Identifier
1255000170
Registry record updated Feb 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
DAKOTA ADULT & PEDIATRIC PSYCHIATRY
Practice address
4541 52ND Ave S
Ste 100
Fargo, ND 58104-5565
Phone
(701) 552-6578
Fax
(701) 380-5115
NPI assigned
Sep 13, 2021
Last updated
Feb 16, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2024

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

Authorized official

Name
Dr. Douglas James Hess, DONPI 1679864441
Title
President
Phone
(701) 552-6578

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X Primary
Child & Adolescent Psychiatry Physician 2084P0804X
Medical Specialty Clinic/Center 261QM2500X

Addresses

Primary practice location

4541 52ND Ave S
Ste 100
Fargo, ND 58104-5565

Mailing address

4541 52ND Ave S
Ste 100
Fargo, ND 58104-5565
Phone (701) 552-6578

Other identifiers 1

IdentifierTypeStateIssuer
1679864441OtherNPI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
35D2262078Dakota Adult & Pediatric Psychiatry, PC4541 52ND Ave S Suite 100, Fargo, ND 58104Certificate of waiverJun 8, 2028

National Provider Directory

National Provider Directory

Locations

4541 52nd Ave S
#100
Fargo, ND 58104
Phone (701) 552-6578

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1631491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708041600000",
    "number": "1255000170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4541 52ND AVE S",
            "address_2": "STE 100",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581045565",
            "telephone_number": "701-552-6578",
            "fax_number": "701-380-5115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4541 52ND AVE S",
            "address_2": "STE 100",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581045565",
            "telephone_number": "701-552-6578",
            "fax_number": "701-380-5115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAKOTA ADULT & PEDIATRIC PSYCHIATRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-13",
        "last_updated": "2024-02-16",
        "certification_date": "2024-02-15",
        "status": "A",
        "authorized_official_last_name": "HESS",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "701-552-6578",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1679864441",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.