Dawn Marie Berdahl, FOSTER CARE LICENSEE

Primary specialty

Foster Care AgencyTaxonomy code 253J00000X

License

1049169-2-AFC Issued in MN

Practice address

26019 55TH Ave
Ogilvie, MN 56358-2901

Phone

(320) 272-0032

NPI assigned

Mar 7, 2011

Last updated

Mar 7, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dawn Marie Johnson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1299456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299456000000",
    "number": "1861790420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26019 55TH AVE",
            "city": "OGILVIE",
            "state": "MN",
            "postal_code": "563582901",
            "telephone_number": "320-272-0032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26019 55TH AVE",
            "city": "OGILVIE",
            "state": "MN",
            "postal_code": "563582901",
            "telephone_number": "320-272-0032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERDAHL",
        "first_name": "DAWN",
        "middle_name": "MARIE",
        "credential": "FOSTER CARE LICENSEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-07",
        "last_updated": "2011-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "253J00000X",
            "taxonomy_group": "",
            "desc": "Foster Care Agency",
            "state": "MN",
            "license": "1049169-2-AFC",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAWN",
            "last_name": "JOHNSON",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Foster Care Agency in Ogilvie, MN
• Providers in Ogilvie, MN by specialty
• Foster Care Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2011; 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.