Active NPI
Gregory Joseph Pawlik
- Occupational Therapy Assistant
- Fargo, ND
National Provider Identifier
1851806764
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- Practice address
- 415 4TH St N
Fargo, ND 58102-4514 - Phone
- (701) 446-1014
- Fax
- (701) 446-1200
- NPI assigned
- Dec 14, 2017
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | Primary |
Addresses
Primary practice location
415 4TH St N
Fargo, ND 58102-4514
Mailing address
415 4TH St N
Fargo, ND 58102-4514
Phone (701) 446-1014
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2242ZOOOOOX | 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)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fargo Public Schools | Single Specialty | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1513209600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1513209600000",
"number": "1851806764",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "415 4TH ST N",
"city": "FARGO",
"state": "ND",
"postal_code": "581024514",
"telephone_number": "701-446-1014",
"fax_number": "701-446-1200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "415 4TH ST N",
"city": "FARGO",
"state": "ND",
"postal_code": "581024514",
"telephone_number": "701-446-1014",
"fax_number": "701-446-1200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAWLIK",
"first_name": "GREGORY",
"middle_name": "JOSEPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-12-14",
"last_updated": "2017-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Occupational Therapy Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2242ZOOOOOX",
"state": "ND"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fargo, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 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.