Individual provider Active NPI

Elizabeth Tammi Osowski, CPNP

  • Pediatric Nurse Practitioner
  • Fargo, ND
National Provider Identifier
1730497660
Registry record updated Nov 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
R31112 Issued in ND
Practice address
2701 13TH Ave S
Fargo, ND 58103-3602
Phone
(701) 234-3600
Fax
(701) 234-3515
NPI assigned
Sep 14, 2010
Last updated
Nov 11, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X R31112 ND Primary

Addresses

Primary practice location

2701 13TH Ave S
Fargo, ND 58103-3602

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074

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
I20101110001068 ND Practitioner - Nurse Practitioner 6305031857 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R31112NDMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Medical Center Fargo CurrentSince May 16, 2011 Accepting new patients
Sanford Medical Center Fargo CurrentSince May 16, 2011 Accepting new patients
Sanford Medical Center Fargo Past Accepting new patients

Locations

1720 University Dr S
Fargo, ND 58103
Phone (701) 280-4140

2400 32nd Ave S
Fargo, ND 58103
Phone (701) 234-8800

2701 13th Ave S
Fargo, ND 58103
Phone (701) 234-3600

820 4th St N
Fargo, ND 58102
Phone (701) 234-6161

1220 Sheyenne St
West Fargo, ND 58078
Phone (701) 234-4445

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": "1284422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636588800000",
    "number": "1730497660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 13TH AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581033602",
            "telephone_number": "701-234-3600",
            "fax_number": "701-234-3515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSOWSKI",
        "first_name": "ELIZABETH",
        "middle_name": "TAMMI",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-14",
        "last_updated": "2021-11-11",
        "certification_date": "2021-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "ND",
            "license": "R31112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.