Active NPI
Plastic Surgery Institute, PC
- Plastic Surgery Physician
- Fargo, ND
National Provider Identifier
1477638864
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic Surgery Physician
- 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, 2011
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11131 | Medicaid | ND | |
| 03T03AB | Other | MN | BS MINNESOTA |
| 834693300 | Medicaid | MN | |
| 1163001 | Other | ND | BS N DAKOTA |
National Provider Directory
National Provider DirectoryLocations
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.
-
- Surgery Physician
- St Petersburg, FL
- NPI 1669474805
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.