Debra Andvik, PAC

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PAC0194 Issued in ND

Practice address

3280 20TH St S
Fargo, ND 58104-5917

Phone

(701) 499-4800

Fax

(701) 451-9452

NPI assigned

Oct 24, 2006

Last updated

Mar 4, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Interoperability endpoints

• Direct secure messaging: debra.andvik@146236517318660.direct.elationemr.com

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.

• Plains Medical Clinic, LLC

  • Family Medicine Physician
  • Fargo, ND
  • NPI 1073698460
  Medicare reassignment

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236124800000",
    "number": "1821172404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3280 20TH ST S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581045917",
            "telephone_number": "701-499-4800",
            "fax_number": "701-451-9452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3280 20TH ST S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581045917",
            "telephone_number": "701-499-4800",
            "fax_number": "701-451-9452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDVIK",
        "first_name": "DEBRA",
        "name_prefix": "Mrs.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-24",
        "last_updated": "2009-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "ND",
            "license": "PAC0194",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MNBS",
            "identifier": "212K9AN",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "048592600",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00189293",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "16541",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NDBS",
            "identifier": "024067",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Victoria Anderson
• Mercy Oforiwaa Andoh
• Andrew Wagner Chiropractic LLC
• Massa Julia Andrews, 3747P1801X
• Jordan Cole Andrud
• Vicki L Andvik, PA-C
• Anesthesia Resources
• Angela Darveaux, OD, PC
• Robert Anthony Angotti, LIC. AC., DIPL. OM
• Ani Mangold Psychological Services PLLC

• Medical Physician Assistant in Fargo, ND
• Providers in Fargo, ND by specialty
• Medical Physician Assistant in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2009; 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.

Verify at the official NPI Registry.