Prairie Sinus Ear & Allergy PC

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

11025 Issued in ND

Legal business name

PRAIRIE SINUS EAR & ALLERGY PC

Practice address

3000 N 14TH St
3Rd Floor
Bismarck, ND 58503-0697

Phone

(701) 630-0100

NPI assigned

Mar 19, 2017

Organization subpart

No

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

Authorized official

Name

Jay D Raisen, MD

Title

Owner

Phone

(701) 630-0100

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1489881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490054400000",
    "number": "1699216945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1215",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585021215",
            "telephone_number": "701-630-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 N 14TH ST",
            "address_2": "3RD FLOOR",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585030697",
            "telephone_number": "701-630-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRAIRIE SINUS EAR & ALLERGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-19",
        "last_updated": "2017-03-21",
        "status": "A",
        "authorized_official_last_name": "RAISEN",
        "authorized_official_first_name": "JAY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "701-630-0100",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "ND",
            "license": "11025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Otolaryngology Physician in Bismarck, ND
• Providers in Bismarck, ND by specialty
• Otolaryngology Physician in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2017; 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.