NPIMap

Organization Active NPI

Northwest Dakota Management LLC

Doing business as Dakota Physicians Group

  • Clinic/Center
  • Minot, ND
National Provider Identifier
1669216974
Registry record updated Sep 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
NORTHWEST DAKOTA MANAGEMENT LLC
Doing business as
Dakota Physicians Group
Practice address
1002 18TH Avenue SE
Minot, ND 58701
Phone
(951) 736-0137
NPI assigned
Jun 21, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2026

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

Authorized official

Name
Suzanne Hawthorn
Title
Coordinator
Phone
(951) 736-0137

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

1002 18TH Avenue SE
Minot, ND 58701

Mailing address

2370 Anselmo Dr
Corona, CA 92879-7106
Phone (951) 736-0137

Other names 1

  • Dakota Physicians Group Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241119001636 ND Part B Supplier - Clinic/Group Practice 3678008331 Receives reassigned benefits from 7 practitioners
Practice locations: Minot, ND

National Provider Directory

National Provider Directory
Tax ID family
Dakota Physicians Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Member of 3

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1718928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789344000000",
    "number": "1669216974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2370 ANSELMO DR",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928797106",
            "telephone_number": "951-736-0137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 18TH AVENUE SE",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "58701",
            "telephone_number": "951-736-0137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST DAKOTA MANAGEMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-21",
        "last_updated": "2026-09-14",
        "certification_date": "2026-09-14",
        "status": "A",
        "authorized_official_last_name": "HAWTHORN",
        "authorized_official_first_name": "SUZANNE",
        "authorized_official_title_or_position": "COORDINATOR",
        "authorized_official_telephone_number": "951-736-0137"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dakota Physicians Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dakota Physicians Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Sep 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.