Individual provider Active NPI

Paul G Drown, PA

  • Physician Assistant
  • Grand Forks, ND
National Provider Identifier
1669563672
Registry record updated Mar 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PAC0094 Issued in ND
Practice address
1599 J St
Grand Forks, ND 58205-6306
Phone
(701) 747-5552
NPI assigned
Sep 27, 2006
Last updated
Mar 20, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PAC0094 ND Primary

Addresses

Primary practice location

1599 J St
Grand Forks, ND 58205-6306

Mailing address

1599 J St
Grand Forks, ND 58205-6306
Phone (701) 747-5552

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111214000261 ND Practitioner - Physician Assistant 5799950192 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PAC0094NDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Altru Health System CurrentSince Sep 19, 2011 Accepting new patients
Altru Health System CurrentSince Sep 19, 2011 Accepting new patients

Locations

1001 7th St NE
Devils Lake, ND 58301
Phone (701) 662-2157

1000 S Columbia Rd
Grand Forks, ND 58201
Phone (701) 780-5089

1380 S Columbia Rd
Grand Forks, ND 58201
Phone (701) 795-2000

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205971200000",
    "number": "1669563672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1599 J ST",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582056306",
            "telephone_number": "701-747-5552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1599 J ST",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582056306",
            "telephone_number": "701-747-5552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DROWN",
        "first_name": "PAUL",
        "middle_name": "G",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2008-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ND",
            "license": "PAC0094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Forks, ND

Sources for this page

Verify at the official NPI Registry.