Anthony James Kotnik, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4706 Issued in ND

Practice address

164 W 13TH Street
Unity Medical Center
Grafton, ND 58237-1896

Phone

(701) 352-1620

Fax

(701) 352-1671

NPI assigned

Dec 30, 2005

Reactivated

Mar 26, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Christian Unity Hospital Corporation

  dba Grafton Family Clinic

  • Rural Health Clinic/Center
  • Grafton, ND
  • NPI 1558423665
  NPD

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

{
    "created_epoch": "1135900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386621209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "164 W 13TH ST",
            "address_2": "UNITY MEDICAL CENTER",
            "city": "GRAFTON",
            "state": "ND",
            "postal_code": "582371896",
            "telephone_number": "701-352-1620",
            "fax_number": "701-352-1671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "164 W 13TH STREET",
            "address_2": "UNITY MEDICAL CENTER",
            "city": "GRAFTON",
            "state": "ND",
            "postal_code": "582371896",
            "telephone_number": "701-352-1620",
            "fax_number": "701-352-1671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTNIK",
        "first_name": "ANTHONY",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-30",
        "last_updated": "2007-07-08",
        "deactivation_date": "2006-01-11",
        "reactivation_date": "2007-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ND",
            "license": "4706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sooyoon Kim
• McKinzie Kipp
• Timothy Lynn Koehn
• Karly Koenig, SLP
• Paul Douglas Kolstoe, PH.D.
• Lon Kratochvil, PT
• Kelly Larson, SLP
• John Brian Leclerc, OTR/L
• Tammy Rae Lee
• Lyndsey Rae Leehan, NP

• Family Medicine Physician in Grafton, ND
• Providers in Grafton, ND by specialty
• Family Medicine Physician in North Dakota

• 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.

Verify at the official NPI Registry.