GRAND FORKS FOOT AND ANKLE CLINIC PLLC NPI 1164647822

NPI Information

NPI: 1164647822
Provider Name: GRAND FORKS FOOT AND ANKLE CLINIC, PLLC
Classification: Podiatrist - 213ES0103X
Entity Type: Organization

Specialization: Foot & Ankle Surgery

Address:
1451 44TH AVE S STE 128D
GRAND FORKS, ND
ZIP 58201
Phone: (701) 738-2770
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GRAND FORKS FOOT AND ANKLE CLINIC, PLLC is a foot and ankle surgery podiatrist in Grand Forks, ND. GRAND FORKS FOOT AND ANKLE CLINIC, PLLC NPI is 1164647822. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1451 44TH AVE S STE 128D
GRAND FORKS, ND
ZIP 58201-434
Phone: (701) 738-2770

The provider's authorized official is John Carlyle Miller .
The authorized official title is President and has the following contact phone number (701) 738-2770.

The enumeration date for this NPI number is 4/16/2007 and was last updated on 3/14/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	213ES0103X	Podiatrist	Foot & Ankle Surgery	48	NORTH DAKOTA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	06740-001	OTHER	NORTH DAKOTA	BLURE CROSS BLUE SHIELD
2	711805	MEDICARE ID-TYPE UNSPECIFIED	NORTH DAKOTA
3	13707	MEDICAID	NORTH DAKOTA
4	5651050001	MEDICARE NSC	NORTH DAKOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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