Active NPI
Mariaha Jane Cobb, M.D.
- Ophthalmology Physician
- Fargo, ND
National Provider Identifier
1679955280
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 15881
- Practice address
- 2101 Elm St N
Fargo, ND 58102-2417 - Phone
- (701) 364-3300
- NPI assigned
- Jun 19, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 66645 | MN | |
| Ophthalmology Physician | 207W00000X | 15881 | ND | Primary |
Addresses
Primary practice location
2101 Elm St N
Fargo, ND 58102-2417
Mailing address
2101 Elm St N
Fargo, ND 58102-2417
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ND, MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7524 | NE | MD | Social Worker |
| 66645 | MN | MD | Ophthalmology Physician |
| 15881 | ND | MD | Ophthalmology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Innovis Health LLC | Current | Accepting new patients | |
| Innovis Health, LLC | Current | Accepting new patients | |
| St Mary'S Regional Health Center | Current | Accepting new patients | |
| St. Marys Regional Health Center | Current | Accepting new patients | |
| St Mary'S Regional Health Center | Current | Accepting new patients | |
| Innovis Health LLC | Current | Accepting new patients |
Locations
1027 Washington Ave
Detroit Lakes, MN 56501
Phone (218) 844-2300
3000 32nd Ave S
Fargo, ND 58103
Phone (701) 364-3000
1702 University Dr S
Fargo, ND 58103
Phone (701) 364-4222
Organizations & group practices 6
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Acute Care Hospital
- Fargo, ND
- NPI 1215125463
-
- Rural Acute Care Hospital
- Detroit Lakes, MN
- NPI 1679561088
-
- Multi-Specialty Clinic/Center
- Fargo, ND
- NPI 1144776576
-
- Family Medicine Physician
- Fargo, ND
- NPI 1255677084
-
- Rural Health Clinic/Center
- Walker, MN
- NPI 1558607408
-
- Rural Health Clinic/Center
- Frazee, MN
- NPI 1902364482
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1434672000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1740528000000",
"number": "1679955280",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2101 ELM ST N",
"city": "FARGO",
"state": "ND",
"postal_code": "581022417"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2101 ELM ST N",
"city": "FARGO",
"state": "ND",
"postal_code": "581022417",
"telephone_number": "701-364-3300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COBB",
"first_name": "MARIAHA",
"middle_name": "JANE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-06-19",
"last_updated": "2025-02-26",
"certification_date": "2025-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "MN",
"license": "66645",
"primary": false
},
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "ND",
"license": "15881",
"primary": true
}
],
"identifiers": [],
"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 Feb 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.