Crystal Ann Magsam Amundson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PAC0918 Issued in ND

Practice address

3902 13TH Ave S
Fargo, ND 58103-3357

Phone

(701) 364-6600

NPI assigned

Jun 25, 2021

Last updated

Feb 16, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1624579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644969600000",
    "number": "1659941318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1702 UNIVERSITY DR S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581034940",
            "telephone_number": "701-364-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3902 13TH AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581033357",
            "telephone_number": "701-364-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMUNDSON",
        "first_name": "CRYSTAL",
        "middle_name": "ANN MAGSAM",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-25",
        "last_updated": "2022-02-16",
        "certification_date": "2021-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "13928",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ND",
            "license": "PAC0918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Helei Amini
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• Nicole Lynn Amsbaugh, PA-C
• Brady Amundson
• Cole Amundson, DO
• Troy Amunrud
• Anda Chiropractic, PLLC
• Geoffrey Leigh Anda, D.C.
• London Andel
• Andersen Counseling, PC

• Physician Assistant in Fargo, ND
• Providers in Fargo, ND by specialty
• Physician Assistant in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2022; 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.