NPIMap

Organization Active NPI

Milestone Therapeutics Inc

  • Rehabilitation Clinic/Center
  • Fargo, ND
National Provider Identifier
1861540064
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
MILESTONE THERAPEUTICS INC
Practice address
921 43Rd Ave N
Fargo, ND 58102-5320
Phone
(701) 793-3646
Fax
(701) 293-6892
NPI assigned
Jan 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Stephen Preston Olson, OTRL
Title
President
Phone
(701) 793-3646

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X Primary

Addresses

Primary practice location

921 43Rd Ave N
Fargo, ND 58102-5320

Mailing address

921 43Rd Ave N
Fargo, ND 58102-5320
Phone (701) 793-3646

Other identifiers 7

IdentifierTypeStateIssuer
1042648OtherNDPREFERRED ONE PROV. NUM.
6345001OtherNDBCBS ND CLINIC NUMBER
64-05519OtherNDMEDICA PROVIDER NUMBER
54893OtherNDND MA PROVIDER NUMBER
107041OtherNDHEALTH PARTNERS PROV. #
371G1MIOtherNDEPNI PROVIDER NUMBER
371G1MIOtherMNBCBS MN PROVIDER NUMBER

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1168128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1861540064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 43RD AVE N",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581025320",
            "telephone_number": "701-793-3646",
            "fax_number": "701-293-6892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 43RD AVE N",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581025320",
            "telephone_number": "701-793-3646",
            "fax_number": "701-293-6892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILESTONE THERAPEUTICS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "OLSON",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "PRESTON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "701-793-3646",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "OTRL"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE PROV. NUM.",
            "identifier": "1042648",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ND CLINIC NUMBER",
            "identifier": "6345001",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA PROVIDER NUMBER",
            "identifier": "64-05519",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ND MA PROVIDER NUMBER",
            "identifier": "54893",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS PROV. #",
            "identifier": "107041",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EPNI PROVIDER NUMBER",
            "identifier": "371G1MI",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MN PROVIDER NUMBER",
            "identifier": "371G1MI",
            "state": "MN"
        }
    ],
    "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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.