NPIMap

Individual provider Active NPI

Lindsey Jo Dahl, M.D

  • Internal Medicine Physician
  • Fargo, ND
National Provider Identifier
1962529446
Registry record updated Jan 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
11583 Issued in ND
Practice address
2400 32ND Ave S
Fargo, ND 58103-5800
Phone
(701) 234-8820
NPI assigned
Mar 22, 2007
Last updated
Jan 18, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2004015384 MO
Internal Medicine Physician 207R00000X 11583 ND Primary

Addresses

Primary practice location

2400 32ND Ave S
Fargo, ND 58103-5800

Mailing address

2400 32ND Ave S
Fargo, ND 58103-5800
Phone (701) 234-8820

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND, MN2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20101007000592 ND Practitioner - Internal Medicine 9335200864 Reassigns benefits to 1 organization
I20220305000137 MN Practitioner - Internal Medicine 9335200864 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Creighton University School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanford Medical Center FargoGroup PAC ID 8426967803, 1,210 clinicians

Practice addresses (Care Compare)

1220 Sheyenne St
West Fargo, ND 58078-2637
Phone (701) 234-4445

2400 32ND Ave S
Fargo, ND 58103-5800
Phone (701) 234-2000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2004015384MOMDInternal Medicine Physician
11583NDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Medical Center Fargo Internal Medicine CurrentSince May 23, 2011 Accepting new patients
Sanford Medical Center Fargo CurrentSince May 23, 2011 Accepting new patients
Elim Homes, Inc Past Accepting new patients

Locations

2400 32nd Ave S
Fargo, ND 58103
Phone (701) 234-8800

1220 Sheyenne St
West Fargo, ND 58078
Phone (701) 234-4445

Organizations & group practices 3

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.

Hospital & facility affiliations 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326844800000",
    "number": "1962529446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 32ND AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581035800",
            "telephone_number": "701-234-8820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 32ND AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581035800",
            "telephone_number": "701-234-8820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAHL",
        "first_name": "LINDSEY",
        "middle_name": "JO",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-22",
        "last_updated": "2012-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2004015384",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ND",
            "license": "11583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.