NPIMap

Organization Active NPI

Faa Addiction Services

  • Addiction (Substance Use Disorder) Counselor
  • Minot, ND
National Provider Identifier
1659926681
Registry record updated Feb 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Legal business name
FAA ADDICTION SERVICES
Practice address
900 N Broadway Ste 111
Minot, ND 58703-2378
Phone
(701) 537-4191
NPI assigned
Aug 6, 2019
Last updated
Feb 5, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2020

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

Authorized official

Name
Shondell Gantzer
Title
Office Manager
Phone
(701) 720-2964

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X Primary

Addresses

Primary practice location

900 N Broadway Ste 111
Minot, ND 58703-2378

Mailing address

900 N Broadway Ste 111
Minot, ND 58703-2378
Phone (701) 537-4191

Other identifiers 1

IdentifierTypeStateIssuer
159488MedicaidND

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nathanfaa@hotmail.com Direct

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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": "1565049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580860800000",
    "number": "1659926681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 N BROADWAY STE 111",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587032378",
            "telephone_number": "701-537-4191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 N BROADWAY STE 111",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587032378",
            "telephone_number": "701-537-4191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAA ADDICTION SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-06",
        "last_updated": "2020-02-05",
        "certification_date": "2020-02-05",
        "status": "A",
        "authorized_official_last_name": "GANTZER",
        "authorized_official_first_name": "SHONDELL",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "701-720-2964"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "159488",
            "state": "ND"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nathanfaa@hotmail.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "900 N Broadway Ste 111",
            "city": "Minot",
            "state": "ND",
            "country_code": "US",
            "postal_code": "587032378",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Feb 5, 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.