Active NPI
George Mark Repp, MD
- Anatomic Pathology & Clinical Pathology Physician
- Minot, ND
National Provider Identifier
1376557041
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- 6793
- Practice address
- 1 Burdick Expy W
Minot, ND 58701 - Phone
- (701) 857-5214
- Fax
- (701) 857-5021
- NPI assigned
- Jul 28, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 6793 | ND | Primary |
Addresses
Primary practice location
1 Burdick Expy W
Minot, ND 58701
Mailing address
PO Box 5010
Minot, ND 58702-5010
Phone (701) 857-5650
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6793 | ND | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1376557041",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5010",
"city": "MINOT",
"state": "ND",
"postal_code": "587025010",
"telephone_number": "701-857-5650",
"fax_number": "701-857-5031"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 BURDICK EXPY W",
"city": "MINOT",
"state": "ND",
"postal_code": "58701",
"telephone_number": "701-857-5214",
"fax_number": "701-857-5021"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REPP",
"first_name": "GEORGE",
"middle_name": "MARK",
"name_prefix": "Mr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "ND",
"license": "6793",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minot, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.