Individual provider Active NPI

Paul B Jahn, MD

  • Diagnostic Radiology Physician
  • Bismarck, ND
National Provider Identifier
1902966856
Registry record updated Oct 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
6777 Issued in ND
Practice address
310 N 10TH Street
Bismarck, ND 58501-4516
Phone
(701) 530-7500
Fax
(701) 530-7484
NPI assigned
Dec 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 42515 MN
Vascular & Interventional Radiology Physician 2085R0204X 42515 MN
Diagnostic Radiology Physician 2085R0202X 6777 ND Primary

Addresses

Primary practice location

310 N 10TH Street
Bismarck, ND 58501-4516

Mailing address

PO Box 2698
Bismarck, ND 58502-2698
Phone (218) 786-3230

Other identifiers 2

IdentifierTypeStateIssuer
17774MedicaidND
797325000MedicaidMN

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
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
6777NDMDDiagnostic Radiology Physician
42515MNMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Missouri Basin Anesthesia, PLLC Past Accepting new patients
Adventhealth West Florida Imaging Inc PastSince Jan 1, 2021 Accepting new patients

Organizations & group practices 2

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": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349913600000",
    "number": "1902966856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2698",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585022698",
            "telephone_number": "218-786-3230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 N 10TH STREET",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585014516",
            "telephone_number": "701-530-7500",
            "fax_number": "701-530-7484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAHN",
        "first_name": "PAUL",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2012-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MN",
            "license": "42515",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "MN",
            "license": "42515",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "ND",
            "license": "6777",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "17774",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "797325000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bismarck, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2012; 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.