Michael Mahoney Internal Medicine, Inc.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

MICHAEL MAHONEY INTERNAL MEDICINE, INC.

Practice address

3409 45TH St S Ste 106
Fargo, ND 58104-8970

Phone

(701) 354-7479

NPI assigned

Feb 18, 2021

Organization subpart

No

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

Authorized official

Name

Beth Horvatich

Title

Director of Ops

Phone

(402) 614-4969

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Amy Shultz, DNP, APRN, FNP-C

  • Family Nurse Practitioner
  • Fargo, ND
  • NPI 1952173668
  NPD (past)
• Marilyn Ek, NP-C

  • Family Nurse Practitioner
  • Moorhead, MN
  • NPI 1487745493
  NPD (past)

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

{
    "created_epoch": "1613606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620000000000",
    "number": "1366035420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2255 S 132ND ST STE 100",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681442573",
            "telephone_number": "402-614-4969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3409 45TH ST S STE 106",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581048970",
            "telephone_number": "701-354-7479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL MAHONEY INTERNAL MEDICINE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-18",
        "last_updated": "2021-05-03",
        "certification_date": "2021-05-03",
        "status": "A",
        "authorized_official_last_name": "HORVATICH",
        "authorized_official_first_name": "BETH",
        "authorized_official_title_or_position": "DIRECTOR OF OPS",
        "authorized_official_telephone_number": "402-614-4969"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shane M Meyer, PA-C
• Thomas Carl Meyer, CRNA
• Vickie R Meyer, R.N.
• Catherine Meyers
• Karisa J Meyhuber
• Youstina Michael, M.D
• Daniel G Mickelson, MD
• Jessica L Mickelson, LSW
• Karyssa Mickelson
• Katelyn Ann Mickelson

• General Practice Physician in Fargo, ND
• Providers in Fargo, ND by specialty
• General Practice Physician in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.