Organization Active NPI

Plastic Surgery Institute, PC

  • Plastic Surgery Physician
  • Fargo, ND
National Provider Identifier
1477638864
Registry record updated Jan 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
Legal business name
PLASTIC SURGERY INSTITUTE, PC
Practice address
3280 20TH St S
Fargo, ND 58104-5917
Phone
(701) 293-7408
Fax
(701) 235-2099
NPI assigned
Oct 26, 2006
Last updated
Jan 3, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2011

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

Authorized official

Name
Margaret Gilbertson
Title
Practice Manager
Phone
(701) 293-7408

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X NU Primary
Surgery Physician 208600000X NU

Addresses

Primary practice location

3280 20TH St S
Fargo, ND 58104-5917

Mailing address

3280 20TH St S
Fargo, ND 58104-5917
Phone (701) 293-7408

Other identifiers 4

IdentifierTypeStateIssuer
11131MedicaidND
03T03ABOtherMNBS MINNESOTA
834693300MedicaidMN
1163001OtherNDBS N DAKOTA

National Provider Directory

National Provider Directory

Locations

6450 38th Ave N
Ste 440
St Petersburg, FL 33710
Phone (727) 347-7661

2810 2nd Ave N
Moorhead, MN 56560
Phone (218) 233-7578

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294012800000",
    "number": "1477638864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3280 20TH ST S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581045917",
            "telephone_number": "701-293-7408",
            "fax_number": "701-235-2099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3280 20TH ST S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581045917",
            "telephone_number": "701-293-7408",
            "fax_number": "701-235-2099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLASTIC SURGERY INSTITUTE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2011-01-03",
        "status": "A",
        "authorized_official_last_name": "GILBERTSON",
        "authorized_official_first_name": "MARGARET",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "701-293-7408"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11131",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS MINNESOTA",
            "identifier": "03T03AB",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "834693300",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS N DAKOTA",
            "identifier": "1163001",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2011; 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.