Individual provider Active NPI

Cody M Baxter

  • Physician Assistant
  • Fargo, ND
National Provider Identifier
1922590181
Registry record updated Aug 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
3625 Lincoln St S Ste C
Fargo, ND 58104-7766
Phone
(701) 532-2458
Fax
(701) 935-7277
NPI assigned
Jun 4, 2018
Last updated
Aug 8, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2023

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 Primary

Addresses

Primary practice location

3625 Lincoln St S Ste C
Fargo, ND 58104-7766

Mailing address

3625 Lincoln St S Ste C
Fargo, ND 58104-7766
Phone (701) 532-2458

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230821003389 ND Practitioner - Physician Assistant 1355690462 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of North Dakota School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Progress Weight Management PLLCGroup PAC ID 1153783246, 5 clinicians

Practice addresses (Care Compare)

3625 Lincoln St S
Suite C
Fargo, ND 58104-7766
Phone (701) 532-2458

National Provider Directory

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

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1528070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691452800000",
    "number": "1922590181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3625 LINCOLN ST S STE C",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581047766",
            "telephone_number": "701-532-2458",
            "fax_number": "701-935-7277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3625 LINCOLN ST S STE C",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581047766",
            "telephone_number": "701-532-2458",
            "fax_number": "701-935-7277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAXTER",
        "first_name": "CODY",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-04",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.