Active NPI
Igmidio A Santos, MD
- Psychiatry Physician
- Bismarck, ND
National Provider Identifier
1730161613
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 4316
- Practice address
- 1237 W Divide Ave
Ste 5
Bismarck, ND 58501-1208 - Phone
- (701) 328-8888
- Fax
- (701) 328-8900
- NPI assigned
- Nov 16, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 4316 | ND | Primary |
Addresses
Primary practice location
1237 W Divide Ave
Ste 5
Bismarck, ND 58501-1208
Mailing address
1237 W Divide Ave
Ste 5
Bismarck, ND 58501-1208
Phone (701) 328-8888
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 260025765 | Other | ND | MEDICARE PTAN |
| 15477 | Medicaid | ND |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Department of Social Dept of SHS Div of Instns | Psychiatry | Past | Accepting new patients |
| Badlands Behavioral Health Clinic | Past | Accepting new patients | |
| Badlands Behavioral Health Clinic | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Dickinson, ND
- NPI 1124072525
-
- Community/Behavioral Health Agency
- Dickinson, ND
- NPI 1952828360
-
- Psychiatric Hospital
- Medical Lake, WA
- NPI 1467440602
Psychiatry
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132099200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1309392000000",
"number": "1730161613",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1237 W DIVIDE AVE",
"address_2": "STE 5",
"city": "BISMARCK",
"state": "ND",
"postal_code": "585011208",
"telephone_number": "701-328-8888",
"fax_number": "701-328-8900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1237 W DIVIDE AVE",
"address_2": "STE 5",
"city": "BISMARCK",
"state": "ND",
"postal_code": "585011208",
"telephone_number": "701-328-8888",
"fax_number": "701-328-8900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANTOS",
"first_name": "IGMIDIO",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-16",
"last_updated": "2011-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "ND",
"license": "4316",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "260025765",
"state": "ND"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "15477",
"state": "ND"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bismarck, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.