Active NPI
Ronald Jay Kopperdahl I
- Driver
- Fargo, ND
National Provider Identifier
1912811738
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Driver
- License
- KOP-60-6932
- Practice address
- 2525 Broadway N Ste 2
Fargo, ND 58102-1439 - Phone
- (701) 232-3231
- NPI assigned
- Sep 29, 2026
- Last updated
- Sep 29, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | KOP-60-6932 | ND | Primary |
Addresses
Primary practice location
2525 Broadway N Ste 2
Fargo, ND 58102-1439
Mailing address
PO Box 126
Horace, ND 58047-0126
Phone (701) 235-5599
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1790640000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1790640000000",
"number": "1912811738",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 126",
"city": "HORACE",
"state": "ND",
"postal_code": "580470126",
"telephone_number": "701-235-5599"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2525 BROADWAY N STE 2",
"city": "FARGO",
"state": "ND",
"postal_code": "581021439",
"telephone_number": "701-232-3231"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOPPERDAHL",
"first_name": "RONALD",
"middle_name": "JAY",
"name_prefix": "Mr.",
"name_suffix": "I",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-09-29",
"last_updated": "2026-09-29",
"certification_date": "2026-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "172A00000X",
"taxonomy_group": "",
"desc": "Driver",
"state": "ND",
"license": "KOP-60-6932",
"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 Sep 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.