Individual provider Active NPI

Sharareh Behmanesh, MD

  • Family Medicine Physician
  • Minot, ND
National Provider Identifier
1902013956
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
RL10255 Issued in ND
Practice address
1201 11TH Ave SW
Minot, ND 58701-4207
Phone
(701) 858-6700
Fax
(701) 858-6749
NPI assigned
May 17, 2007
Sex
Female
Sole proprietor
No

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
RL10255NDMDFamily Medicine Physician

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X RL10255 ND Primary

Addresses

NPPES NPI Registry

Primary practice location

1201 11TH Ave SW
Minot, ND 58701-4207

Mailing address

1201 11TH Ave SW
Minot, ND 58701-4207
Phone (701) 858-6700

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902013956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 11TH AVE SW",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587014207",
            "telephone_number": "701-858-6700",
            "fax_number": "701-858-6749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 11TH AVE SW",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587014207",
            "telephone_number": "701-858-6700",
            "fax_number": "701-858-6749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEHMANESH",
        "first_name": "SHARAREH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ND",
            "license": "RL10255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minot, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.