NPIMap

Organization Active NPI

Dakota Gastroenterology, LTD

  • Ambulatory Surgical Clinic/Center
  • Fargo, ND
National Provider Identifier
1881024271
Registry record updated May 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
DAKOTA GASTROENTEROLOGY, LTD
Practice address
5049 33Rd Ave S
Fargo, ND 58104-7080
Phone
(701) 356-1001
Fax
(701) 639-4550
NPI assigned
Nov 21, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 30, 2019

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

Authorized official

Name
Fadel Nammour, MDNPI 1922039684
Title
Owner
Phone
(701) 356-1001

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

5049 33Rd Ave S
Fargo, ND 58104-7080

Mailing address

5049 33Rd Ave S
Fargo, ND 58104-7080
Phone (701) 356-1001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140716002035 ND Part B Supplier - Clinic/Group Practice 5991921504 Receives reassigned benefits from 5 practitioners
Practice locations: Fargo, ND

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

5049 33rd Ave S
Fargo, ND 58104
Phone (701) 356-1001

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 6

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": "1384992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559174400000",
    "number": "1881024271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5049 33RD AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581047080",
            "telephone_number": "701-356-1001",
            "fax_number": "701-639-4550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5049 33RD AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581047080",
            "telephone_number": "701-356-1001",
            "fax_number": "701-639-4550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAKOTA GASTROENTEROLOGY, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-21",
        "last_updated": "2019-05-30",
        "status": "A",
        "authorized_official_last_name": "NAMMOUR",
        "authorized_official_first_name": "FADEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "701-356-1001",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 May 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.