Active NPI
Kathleen A Nordstrom, M.D.
- Radiation Oncology Physician
- Bismarck, ND
National Provider Identifier
1932240025
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiation Oncology Physician
- License
- 8881
- Practice address
- 500 N 8TH St
Bismarck, ND 58501-4445 - Phone
- (701) 222-6100
- Fax
- (701) 222-6150
- NPI assigned
- Feb 9, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Radiation Oncology Physician | 2085R0001X | 8881 | ND | Primary |
Addresses
Primary practice location
500 N 8TH St
Bismarck, ND 58501-4445
Mailing address
PO Box 5598
Bismarck, ND 58506-5598
Phone (701) 222-6100
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7704010 | Other | SD | DR NORDSTROM SD MEDICAID |
| 920006668 | Other | ND | DR NORDSTROM RR MEDICARE |
| 11727 | Medicaid | ND | |
| 21230 | Other | ND | DR NORDSTROM BCBS |
| 8881 | Other | ND | STATE LIC# |
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)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170979200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1388361600000",
"number": "1932240025",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5598",
"city": "BISMARCK",
"state": "ND",
"postal_code": "585065598",
"telephone_number": "701-222-6100",
"fax_number": "701-222-6150"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 N 8TH ST",
"city": "BISMARCK",
"state": "ND",
"postal_code": "585014445",
"telephone_number": "701-222-6100",
"fax_number": "701-222-6150"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NORDSTROM",
"first_name": "KATHLEEN",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-09",
"last_updated": "2013-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0001X",
"taxonomy_group": "",
"desc": "Radiology, Radiation Oncology",
"state": "ND",
"license": "8881",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DR NORDSTROM SD MEDICAID",
"identifier": "7704010",
"state": "SD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DR NORDSTROM RR MEDICARE",
"identifier": "920006668",
"state": "ND"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "11727",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DR NORDSTROM BCBS",
"identifier": "21230",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LIC#",
"identifier": "8881",
"state": "ND"
}
],
"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 Dec 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.