Rebecca Kopp Dunham PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

REBECCA KOPP DUNHAM PLLC

Practice address

6046 14TH St S
Fargo, ND 58104-7340

Phone

(701) 404-0997

Fax

(701) 566-8876

NPI assigned

Feb 3, 2021

Last updated

Oct 5, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Rebecca Kopp Dunham, LCSWNPI 1659600054

Title

President

Phone

(701) 715-5214

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ND, MN2 enrollments

Enrollment records 2

Locations

Practitioners 1

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.

• Rebecca M Kopp Dunham, LCSW

  • Clinical Social Worker
  • Fargo, ND
  • NPI 1659600054

  MN

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1612310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633392000000",
    "number": "1386235190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6046 14TH ST S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581047340",
            "telephone_number": "701-404-0997",
            "fax_number": "701-566-8876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6046 14TH ST S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581047340",
            "telephone_number": "701-404-0997",
            "fax_number": "701-566-8876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REBECCA KOPP DUNHAM PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-03",
        "last_updated": "2021-10-05",
        "certification_date": "2021-10-05",
        "status": "A",
        "authorized_official_last_name": "KOPP DUNHAM",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "701-715-5214",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sherrie Reading
• Laura J Rear, APRN, DNP, FNP
• Meghann Reardon, M.S.
• Scott T Reardon, M.D.
• John Wallace Reavis
• Amanda Beth Reber, FNP-C
• Rebuilding Together of Fargo-Moorhead Area, Inc.
• Recharge Physical Therapy and Wellness, PLLC (Recharge Physical Therapy & Wellness)
• Recovery Peers LLC
• Recovery Transportation LLC

• Clinical Social Worker in Fargo, ND
• Providers in Fargo, ND by specialty
• Clinical Social Worker in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2021; 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.

Verify at the official NPI Registry.