Active NPI
Andrea Haugen, LRD
- Registered Dietitian
- Fargo, ND
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 441
- Practice address
- 2400 32ND Ave S
Fargo, ND 58103 - Phone
- (701) 234-2000
- Fax
- (701) 234-8803
- NPI assigned
- Jul 18, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 441 | ND | Primary |
Addresses
Primary practice location
2400 32ND Ave S
Fargo, ND 58103
Mailing address
PO Box 5074
Sioux Falls, SD 57117-5074
Phone (701) 234-2000
Other practice location 1
737 Broadway
Fargo, ND 58122-0001
Phone (701) 234-2245
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ND
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101118000589 | ND | Practitioner - Registered Dietitian Or Nutrition Professional | 3971799842 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 441 | ND | MD | Corneal and Contact Management Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sanford Medical Center Fargo | Current | Accepting new patients | |
| Sanford Medical Center Fargo | Current | Accepting new patients | |
| Sanford Medical Center Fargo | Past | Accepting new patients |
Locations
3955 56th St S
Ste D
Fargo, ND 58104
Phone (701) 234-2431
736 Broadway N
Fargo, ND 58102
Phone (701) 234-2353
737 Broadway N
Fargo, ND 58102
Phone (701) 234-4811
820 4th St N
Fargo, ND 58102
Phone (701) 234-6161
2400 32nd Ave S
Fargo, ND 58103
Phone (701) 234-8800
1220 Sheyenne St
West Fargo, ND 58078
Phone (701) 234-4445
Organizations & group practices 3
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.
-
- General Acute Care Hospital
- Fargo, ND
- NPI 1528009412
-
- Home Health Agency
- Fargo, ND
- NPI 1891861761
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649203200000",
"number": "1346268992",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5074",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "571175074",
"telephone_number": "701-234-2000",
"fax_number": "701-234-8803"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2400 32ND AVE S",
"city": "FARGO",
"state": "ND",
"postal_code": "58103",
"telephone_number": "701-234-2000",
"fax_number": "701-234-8803"
}
],
"practiceLocations": [
{
"address_1": "737 Broadway",
"address_purpose": "LOCATION",
"city": "Fargo",
"state": "ND",
"postal_code": "581220001",
"country_code": "US",
"telephone_number": "701-234-2245",
"fax_number": "701-234-3868",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HAUGEN",
"first_name": "ANDREA",
"credential": "LRD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-18",
"last_updated": "2022-04-06",
"certification_date": "2022-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "ND",
"license": "441",
"primary": true
}
],
"identifiers": [],
"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 Apr 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.