NPIMap

Organization Active NPI

Prairie Imaging, PC

  • Diagnostic Radiology Physician
  • Dickinson, ND
National Provider Identifier
1366423618
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
9874 Issued in ND
Legal business name
PRAIRIE IMAGING, PC
Practice address
112 3Rd St W
Dickinson, ND 58601-5136
Phone
(701) 486-4546
Fax
(701) 483-4545
NPI assigned
Nov 11, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Garry K Dunn, M.D.NPI 1639151285
Title
Radiologist
Phone
(701) 483-4546

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X 9874 ND Primary

Addresses

Primary practice location

112 3Rd St W
Dickinson, ND 58601-5136

Mailing address

112 3Rd St W
Dickinson, ND 58601-5136
Phone (701) 486-4546

Other identifiers 2

IdentifierTypeStateIssuer
12750MedicaidND
13281MedicaidND

National Provider Directory

National Provider Directory

Locations

112 3rd St W
Dickinson, ND 58601
Phone (701) 225-0069

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1131667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1366423618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 3RD ST W",
            "city": "DICKINSON",
            "state": "ND",
            "postal_code": "586015136",
            "telephone_number": "701-486-4546",
            "fax_number": "701-483-4545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 3RD ST W",
            "city": "DICKINSON",
            "state": "ND",
            "postal_code": "586015136",
            "telephone_number": "701-486-4546",
            "fax_number": "701-483-4545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRAIRIE IMAGING, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DUNN",
        "authorized_official_first_name": "GARRY",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "RADIOLOGIST",
        "authorized_official_telephone_number": "701-483-4546",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "ND",
            "license": "9874",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12750",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "13281",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dickinson, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.