NPIMap

Individual provider Active NPI

Stephen P Nordmark, MD

  • Internal Medicine Physician
  • Detroit Lakes, MN
National Provider Identifier
1427075985
Registry record updated Dec 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
34421 Issued in MN
Practice address
1245 Washington Ave
Detroit Lakes, MN 56501-3905
Phone
(218) 846-2000
Fax
(218) 846-2114
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 34421 MN Primary

Addresses

Primary practice location

1245 Washington Ave
Detroit Lakes, MN 56501-3905

Mailing address

1245 Washington Ave
Detroit Lakes, MN 56501-3905
Phone (218) 846-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060329000720 MN Practitioner - Internal Medicine 2860400041 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of North Dakota School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanford Medical Center FargoGroup PAC ID 8426967803, 1,210 clinicians

Practice addresses (Care Compare)

1245 Washington Ave
Detroit Lakes, MN 56501-3905
Phone (218) 846-2000

1412 Main St
Hawley, MN 56549
Phone (218) 483-3564

Hospital & facility affiliations

  • Sanford Home Care Fargo Home health agency, Fargo, ND, CCN 357037
  • Hia Hospice Hospice, Fargo, ND, CCN 351500
  • Sanford Medical Center Fargo Hospital, Fargo, ND, CCN 350011
  • Essentia Health St Marys - Detroit Lakes Hospital, Detroit Lakes, MN, CCN 240101
  • Perham Health Hospital, Perham, MN, CCN 241373

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Medical Center Fargo CurrentSince Jul 1, 2022 Accepting new patients
St. Mary'S Regional Health Center CurrentSince Jan 1, 2006 Accepting new patients
St Mary'S Regional Health Center CurrentSince Jan 1, 2006 Accepting new patients
St. Marys Regional Health Center Current Accepting new patients
Sanford Medical Center Fargo Internal Medicine CurrentSince Jul 1, 2022 Accepting new patients
Sanford Medical Center Fargo Past Accepting new patients

Locations

1245 Washington Ave
Detroit Lakes, MN 56501
Phone (218) 846-2000

1027 Washington Ave
Detroit Lakes, MN 56501
Phone (218) 844-2300

4000 28th Ave S
Moorhead, MN 56560
Phone (701) 234-3200

Organizations & group practices 6

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

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322784000000",
    "number": "1427075985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1245 WASHINGTON AVE",
            "city": "DETROIT LAKES",
            "state": "MN",
            "postal_code": "565013905",
            "telephone_number": "218-846-2000",
            "fax_number": "218-846-2114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1245 WASHINGTON AVE",
            "city": "DETROIT LAKES",
            "state": "MN",
            "postal_code": "565013905",
            "telephone_number": "218-846-2000",
            "fax_number": "218-846-2114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORDMARK",
        "first_name": "STEPHEN",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2011-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "34421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit Lakes, MN

Sources for this page

Verify at the official NPI Registry.