Organization Active NPI

Neuropsychology Associates, PA

  • Specialist
  • Fargo, ND
National Provider Identifier
1669420923
Registry record updated Oct 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
171 Issued in ND
Legal business name
NEUROPSYCHOLOGY ASSOCIATES, PA
Practice address
1220 Main Ave Ste 100
Fargo, ND 58103-8201
Phone
(701) 297-7588
Fax
(701) 364-2256
NPI assigned
May 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2010

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

Authorized official

Name
Dr. Rodney Swenson, PH.D. A.B.P.N.NPI 1841413507
Title
President
Phone
(701) 297-7588

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 174400000X 171 ND Primary
SpecialistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 174400000X 226 ND

Addresses

Primary practice location

1220 Main Ave Ste 100
Fargo, ND 58103-8201

Mailing address

1220 Main Ave Ste 100
Fargo, ND 58103-8233
Phone (701) 297-7588

Other identifiers 1

IdentifierTypeStateIssuer
12261MedicaidND

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041012001240 ND Part B Supplier - Clinic/Group Practice 1557321825 Receives reassigned benefits from 4 practitioners
Practice locations: Fargo, ND

National Provider Directory

National Provider Directory

Locations

1220 Main Ave
Ste 100
Fargo, ND 58103
Phone (701) 297-7588

3374 S 31st St
Ste B
Grand Forks, ND 58201
Phone (701) 780-9700

Practitioners & affiliated clinicians

Practitioners 5

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": "1146787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288224000000",
    "number": "1669420923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 MAIN AVE STE 100",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581038233",
            "telephone_number": "701-297-7588",
            "fax_number": "701-364-2256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 MAIN AVE STE 100",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581038201",
            "telephone_number": "701-297-7588",
            "fax_number": "701-364-2256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROPSYCHOLOGY ASSOCIATES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-05",
        "last_updated": "2010-10-28",
        "status": "A",
        "authorized_official_last_name": "SWENSON",
        "authorized_official_first_name": "RODNEY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "701-297-7588",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D. A.B.P.N."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "ND",
            "license": "171",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "ND",
            "license": "226",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12261",
            "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 Oct 28, 2010; 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.