NPIMap

Organization Active NPI

Dakota Clinic, LTD.

  • Family Medicine Physician
  • Medina, ND
National Provider Identifier
1467406181
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
DAKOTA CLINIC, LTD.
Practice address
600 Water Street E
Medina, ND 58467
Phone
(701) 486-3550
Fax
(701) 486-3496
NPI assigned
May 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Larry G Solberg
Title
Administrator-Authorized Official
Phone
(701) 364-3405

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

600 Water Street E
Medina, ND 58467

Mailing address

401 3Rd St SE
Jamestown, ND 58401-4247
Phone (701) 253-5300

Other identifiers 1

IdentifierTypeStateIssuer
10894MedicaidND

Other names 1

  • Dakota Clinic, Ltd. - Medina Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dakota Clinc Independent la38 organizations share this tax ID, including this one

Other organizations with this tax ID 37

Organizations that report the same tax identification number in the National Provider Directory.

View all 37

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1467406181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 3RD ST SE",
            "city": "JAMESTOWN",
            "state": "ND",
            "postal_code": "584014247",
            "telephone_number": "701-253-5300",
            "fax_number": "701-253-5402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 WATER STREET E",
            "city": "MEDINA",
            "state": "ND",
            "postal_code": "58467",
            "telephone_number": "701-486-3550",
            "fax_number": "701-486-3496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAKOTA CLINIC, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SOLBERG",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "ADMINISTRATOR-AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "701-364-3405"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10894",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dakota Clinic, Ltd. - Medina",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Medina, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.