Organization Active NPI

Robin Pursifull LLC

  • Family Nurse Practitioner
  • Minot, ND
National Provider Identifier
1467152694
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
ROBIN PURSIFULL LLC
Practice address
1705 4TH Ave NW
Minot, ND 58703-2912
Phone
(701) 839-0474
NPI assigned
Mar 7, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
Robin Pursifull, NPNPI 1245824838
Title
Owner
Phone
(850) 543-9469

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
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

1705 4TH Ave NW
Minot, ND 58703-2912

Mailing address

3015 16TH St SW Apt 316
Minot, ND 58701-6909
Phone (850) 543-9469

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230905002019 ND Part B Supplier - Clinic/Group Practice 7416310719 Receives reassigned benefits from 1 practitioner
Practice locations: Minot, ND

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1678147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1467152694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3015 16TH ST SW APT 316",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587016909",
            "telephone_number": "850-543-9469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 4TH AVE NW",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587032912",
            "telephone_number": "701-839-0474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBIN PURSIFULL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-07",
        "last_updated": "2023-03-07",
        "certification_date": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "PURSIFULL",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "850-543-9469",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "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 Mar 7, 2023; 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.