Jon Barrett Kolberg, MD

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

11801 Issued in ND

Practice address

225 N 7TH St
Bismarck, ND 58501-4417

Phone

(701) 323-6140

Fax

(701) 323-6907

NPI assigned

May 26, 2009

Last updated

Nov 5, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Sports Medicine

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sanford BismarckGroup PAC ID 9739098575, 562 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sanford Medical Center Bismarck Hospital, Bismarck, ND, CCN 350015

Merit-based Incentive Payment System (MIPS)

Final score

89.63 of 100Reported as group

Quality

89.39

Promoting interoperability

100

Improvement activities

40

Cost

76.04

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Sanford Bismarck

  dba Family Wellness

  • Multi-Specialty Clinic/Center
  • Bismarck, ND
  • NPI 1811941172

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Sanford Bismarck

  dba Sanford East Dickinson Clinic

  • Multi-Specialty Clinic/Center
  • Dickinson, ND
  • NPI 1720075377
  NPD
• Cavalier Optometry Clinic LTD

  • Optometrist
  • Cavalier, ND
  • NPI 1730173238
  NPD (past)
• Clinic Pharmacy Inc

  • Community/Retail Pharmacy
  • Devils Lake, ND
  • NPI 1184718876
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Sanford Bismarck

  dba Sanford MRI Center

  • General Acute Care Hospital
  • Bismarck, ND
  • NPI 1538245634
  Care Compare affiliation

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

{
    "created_epoch": "1243296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667606400000",
    "number": "1790910446",
    "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": "225 N 7TH ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585014417",
            "telephone_number": "701-323-6140",
            "fax_number": "701-323-6907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLBERG",
        "first_name": "JON",
        "middle_name": "BARRETT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-26",
        "last_updated": "2022-11-05",
        "certification_date": "2022-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ND",
            "license": "TRL11212",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "ND",
            "license": "11801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jkolberg6759950@direct.sanfordhealth.org",
            "affiliation": "N",
            "address_1": "225 N 7th St",
            "city": "Bismarck",
            "state": "ND",
            "country_code": "US",
            "postal_code": "585014417",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jason Kobes, ATC ACSM EPC
• Mollie Koble
• Natalie Layne Koch, PHARMD
• Ryan Patrick Koch, D.C.
• Kevin J Koester, DPM
• Nadim Koleilat, MD
• Sierra Kolle, RD
• Elizabeth B Kollie
• Sanya L Kom, LPN
• Godwin Nakpan Konde

• Sports Medicine (Family Medicine) Physician in Bismarck, ND
• Providers in Bismarck, ND by specialty
• Sports Medicine (Family Medicine) Physician in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.