NPIMap

Individual provider Active NPI

Lori Klabunde, PA-C

  • Physician Assistant
  • Bismarck, ND
National Provider Identifier
1912925876
Registry record updated Sep 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA0051 Issued in ND
Practice address
202 E Greenfield LN Ste 100
Bismarck, ND 58503-6597
Phone
(701) 223-7822
Fax
(701) 223-7844
NPI assigned
Jul 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA0051 ND Primary

Addresses

Primary practice location

202 E Greenfield LN Ste 100
Bismarck, ND 58503-6597

Mailing address

202 E Greenfield LN Ste 100
Bismarck, ND 58503-6597
Phone (701) 223-7822

Other identifiers 2

IdentifierTypeStateIssuer
PAC0051OtherNDLICENCE
1464771MedicaidND

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070709000163 ND Practitioner - Physician Assistant 2062512924 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

202 E Greenfield LN
Suite 100
Bismarck, ND 58503-6597
Phone (701) 223-7822

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.82 of 100Reported as group
Quality
100
Improvement activities
40
Cost
66.07

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA0051NDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pain Treatment Center Anesthesiologists PC CurrentSince Sep 25, 2015 Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients

Locations

202 E Greenfield Ln
Ste 100
Bismarck, ND 58503
Phone (701) 223-7822

600 N 9th St
Bismarck, ND 58501
Phone (701) 221-2299

600 N 9th St
Ste 2
Bismarck, ND 58501
Phone (701) 223-7822

Interoperability endpoints

  • Direct secure messaging: lklabunde@ptc-nd.direct.office.nextgen.com
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600905600000",
    "number": "1912925876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 E GREENFIELD LN STE 100",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585036597",
            "telephone_number": "701-223-7822",
            "fax_number": "701-223-7844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 E GREENFIELD LN STE 100",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585036597",
            "telephone_number": "701-223-7822",
            "fax_number": "701-223-7844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLABUNDE",
        "first_name": "LORI",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2020-09-24",
        "certification_date": "2020-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ND",
            "license": "PA0051",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENCE",
            "identifier": "PAC0051",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1464771",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bismarck, ND

Sources for this page

Verify at the official NPI Registry.