ND Medicaid Provider Taxonomy Listing-Individual How to ...

ND Medicaid Provider Taxonomy Listing-Individual

How to Search: Hold Control Key and Press F; Enter your search criteria (NPI #) in the upper right, Click NEXT in the search box

NPI

Taxonomy

Provider Type

Provider Type Description

Specialty Code

Specialty Description

1003006651 207V00000X 020 1003008525 225100000X 022 1003010570 207R00000X 020 1003011396 207ZP0102X 020 1003013020 2085R0202X 020 1003015314 207Q00000X 020 1003017427 2084N0400X 020 1003027517 1223G0001X 012 1003027517 122300000X 012 1003027582 2085R0001X 020 1003038811 363A00000X 036 1003044975 2085R0204X 020 1003045097 208600000X 020 1003045097 2086S0102X 020 1003052556 363A00000X 036 1003055864 235Z00000X 023 1003056961 111N00000X 011 1003061367 2085R0202X 020 1003063751 1041C0700X 010 1003074105 363LP0200X 036 1003076894 207R00000X 020 1003076894 207Q00000X 020 1003079112 2085R0202X 020 1003087081 235Z00000X 023 1003097973 111N00000X 011 1003098401 163W00000X 016 1003100595 207R00000X 020 1003101049 207L00000X 020 1003102419 207L00000X 020 1003102419 207LP3000X 020 1003105958 225100000X 022

Physicians

016

Resp Devl Rehab and Restore Srvc Prov 123

Physicians

011

Physicians

259

Physicians

167

Physicians

173

Physicians

013

Dental Providers

001

Dental Providers

019

Physicians

497

Phys Assts and Advanced Nursing Provs

255

Physicians

189

Physicians

275

Physicians

539

Phys Assts and Advanced Nursing Provs

255

Speech Language and Hearing Svc Prov

272

Chiropractic Providers

047

Physicians

167

Behav Health & Social Svc Prov

191

Phys Assts and Advanced Nursing Provs

435

Physicians

011

Physicians

173

Physicians

167

Speech Language and Hearing Svc Prov

272

Chiropractic Providers

047

Nursing Service Providers

129

Physicians

011

Physicians

005

Physicians

005

Physicians

412

Resp Devl Rehab and Restore Srvc Prov 123

OB/GYN Physical Therapist Internal Medicine Anatomic / Clinical Pathology Diagnostic Radiology Family Medicine Neurology General Practice Dentists Oncology Radiation - Physician Physician Assistant Vascular and Interventional Radiology Surgery Surgical Critical Care Physician Assistant Speech-Language Pathologist Chiropractor Diagnostic Radiology Licensed Clinical Social Worker Nurse Practitioner Pediatrics Internal Medicine Family Medicine Diagnostic Radiology Speech-Language Pathologist Chiropractor Registered Nurse Internal Medicine Anesthesiology Anesthesiology Pediatric Anesthesiology Physical Therapist

1

12/16/2021

ND Medicaid Provider Taxonomy Listing-Individual

NPI

Taxonomy

Provider Type

Provider Type Description

1003122151 207Q00000X 020 1003122987 1041C0700X 010 1003127903 207P00000X 020 1003135013 207T00000X 020 1003137993 363LP0200X 036 1003146861 101YP2500X 010 1003149790 103T00000X 010 1003151564 367500000X 036 1003157371 367500000X 036 1003170952 207R00000X 020 1003202797 208000000X 020 1003222878 225X00000X 022 1003234683 208M00000X 020 1003242256 363LF0000X 036 1003252909 207V00000X 020 1003253634 207W00000X 020 1003255381 363A00000X 036 1003259854 2085R0202X 020 1003265752 106H00000X 010 1003269234 207R00000X 020 1003270687 207X00000X 020 1003271008 101YA0400X 010 1003271784 111N00000X 011 1003278243 2085R0001X 020 1003287079 207R00000X 020 1003291840 363LP0808X 036 1003298316 207L00000X 020 1003298548 207P00000X 020 1003307182 1223G0001X 012 1003314196 104100000X 010 1003314196 1041C0700X 010 1003314261 225X00000X 022

Physicians Behav Health & Social Svc Prov Physicians Physicians Phys Assts and Advanced Nursing Provs Behav Health & Social Svc Prov Behav Health & Social Svc Prov Phys Assts and Advanced Nursing Provs Phys Assts and Advanced Nursing Provs Physicians Physicians Resp Devl Rehab and Restore Srvc Prov Physicians Phys Assts and Advanced Nursing Provs Physicians Physicians Phys Assts and Advanced Nursing Provs Physicians Behav Health & Social Svc Prov Physicians Physicians Behav Health & Social Svc Prov Chiropractic Providers Physicians Physicians Phys Assts and Advanced Nursing Provs Physicians Physicians Dental Providers Behav Health & Social Svc Prov Behav Health & Social Svc Prov Resp Devl Rehab and Restore Srvc Prov

2

Specialty Code

Specialty Description

173

Family Medicine

191

Licensed Clinical Social Worker

270

Emergency Medicine

014

Neurological Surgery

435

Nurse Practitioner Pediatrics

190

Counselor Licensed Prof Clinical

050

Psychologist

341

Certified Registered Nurse Anesthetist

341

Certified Registered Nurse Anesthetist

011

Internal Medicine

049

Pediatrics

126

Occupational Therapy

344

Hospitalist

432

Nurse Practitioner Family

016

OB/GYN

018

Ophthalmology

255

Physician Assistant

167

Diagnostic Radiology

403

Marriage & Family Therapist

011

Internal Medicine

020

Orthopedic Surgery

155

Counselor Addiction

047

Chiropractor

497

Oncology Radiation - Physician

011

Internal Medicine

467

Nurse Practitioner- Psych/Mental Health

005

Anesthesiology

270

Emergency Medicine

001

General Practice

425

Licensed Master Social Worker

191

Licensed Clinical Social Worker

126

Occupational Therapy

12/16/2021

ND Medicaid Provider Taxonomy Listing-Individual

NPI

Taxonomy

Provider Type

Provider Type Description

1003324575 133V00000X 013 1003334830 171M00000X 017 1003345323 207P00000X 020 1003353889 171M00000X 017 1003353889 174400000X 010 1003353889 247200000X 010 1003358755 1223P0221X 012 1003359779 171M00000X 017 1003362427 163W00000X 016 1003363151 225X00000X 022 1003370149 171M00000X 017 1003371782 363LF0000X 036 1003381054 225X00000X 022 1003383878 367500000X 036 1003388638 363LG0600X 036 1003392887 231H00000X 023 1003397316 225100000X 022 1003398389 225100000X 022 1003407412 3747P1801X 048 1003414053 376J00000X 048 1003414053 347C00000X 048 1003414053 3747P1801X 048 1003415563 3747P1801X 048 1003415563 3747P1801X 048 1003416934 225X00000X 022 1003418013 3747P1801X 048 1003418013 3747P1801X 048 1003419847 347C00000X 048 1003419847 372600000X 048 1003419847 3747P1801X 048 1003419847 3747P1801X 048 1003419847 376J00000X 048

Dietary & Nutritional Service Providers Other Service Providers Physicians Other Service Providers Behav Health & Social Svc Prov Behav Health & Social Svc Prov Dental Providers Other Service Providers Nursing Service Providers Resp Devl Rehab and Restore Srvc Prov Other Service Providers Phys Assts and Advanced Nursing Provs Resp Devl Rehab and Restore Srvc Prov Phys Assts and Advanced Nursing Provs Phys Assts and Advanced Nursing Provs Speech Language and Hearing Svc Prov Resp Devl Rehab and Restore Srvc Prov Resp Devl Rehab and Restore Srvc Prov Qualified Service Provider Qualified Service Provider Qualified Service Provider Qualified Service Provider Qualified Service Provider Qualified Service Provider Resp Devl Rehab and Restore Srvc Prov Qualified Service Provider Qualified Service Provider Qualified Service Provider Qualified Service Provider Qualified Service Provider Qualified Service Provider Qualified Service Provider

3

Specialty Code

Specialty Description

056

Licensed Registered Dietician

335

Case Manager/Care Coordinator

270

Emergency Medicine

335

Case Manager/Care Coordinator

488

Behavior Modification Specialist

492

Mental Health Technician

063

Pedodontics

335

Case Manager/Care Coordinator

129

Registered Nurse

126

Occupational Therapy

335

Case Manager/Care Coordinator

432

Nurse Practitioner Family

126

Occupational Therapy

341

Certified Registered Nurse Anesthetist

551

Nurse Practitioner Gerontology

087

Audiologist

123

Physical Therapist

123

Physical Therapist

399

Personal Care-Unit Rate

180

Homemaker

327

Non-Med Transp (Escort)

399

Personal Care-Unit Rate

251

Personal Care-Daily Rate

399

Personal Care-Unit Rate

126

Occupational Therapy

399

Personal Care-Unit Rate

251

Personal Care-Daily Rate

327

Non-Med Transp (Escort)

513

Supervision

399

Personal Care-Unit Rate

081

Respite Care

180

Homemaker

12/16/2021

ND Medicaid Provider Taxonomy Listing-Individual

NPI

Taxonomy

Provider Type

Provider Type Description

1003420175 103K00000X 010 1003420175 106S00000X 010 1003422478 363LF0000X 036 1003427642 235Z00000X 023 1003430786 171M00000X 017 1003433301 363LF0000X 036 1003434879 235Z00000X 023 1003446097 367500000X 036 1003451204 225100000X 022 1003452822 111N00000X 011 1003459447 247200000X 010 1003462201 174400000X 010 1003468893 163W00000X 016 1003468984 207Q00000X 020 1003472317 363L00000X 036 1003473752 235Z00000X 023 1003477894 363L00000X 036 1003483934 208600000X 020 1003496589 104100000X 010 1003497488 363LF0000X 036 1003573510 171M00000X 049 1003583709 171M00000X 049 1003583709 171M00000X 049 1003583709 171M00000X 049 1003583709 171M00000X 049 1003583709 172A00000X 049 1003583709 171M00000X 049 1003802430 208200000X 020 1003805730 1223G0001X 012 1003805730 122300000X 012 1003811316 363A00000X 036 1003814484 111N00000X 011

Behav Health & Social Svc Prov Behav Health & Social Svc Prov Phys Assts and Advanced Nursing Provs Speech Language and Hearing Svc Prov Other Service Providers Phys Assts and Advanced Nursing Provs Speech Language and Hearing Svc Prov Phys Assts and Advanced Nursing Provs Resp Devl Rehab and Restore Srvc Prov Chiropractic Providers Behav Health & Social Svc Prov Behav Health & Social Svc Prov Nursing Service Providers Physicians Phys Assts and Advanced Nursing Provs Speech Language and Hearing Svc Prov Phys Assts and Advanced Nursing Provs Physicians Behav Health & Social Svc Prov Phys Assts and Advanced Nursing Provs 1915i State Plan Amendment Services 1915i State Plan Amendment Services 1915i State Plan Amendment Services 1915i State Plan Amendment Services 1915i State Plan Amendment Services 1915i State Plan Amendment Services 1915i State Plan Amendment Services Physicians Dental Providers Dental Providers Phys Assts and Advanced Nursing Provs Chiropractic Providers

4

Specialty Code

Specialty Description

567

Behavior Analyst

568

Behavior Technician

432

Nurse Practitioner Family

272

Speech-Language Pathologist

335

Case Manager/Care Coordinator

432

Nurse Practitioner Family

272

Speech-Language Pathologist

341

Certified Registered Nurse Anesthetist

123

Physical Therapist

047

Chiropractor

492

Mental Health Technician

488

Behavior Modification Specialist

129

Registered Nurse

173

Family Medicine

055

Nurse Practitioner Advanced Practice

272

Speech-Language Pathologist

055

Nurse Practitioner Advanced Practice

275

Surgery

425

Licensed Master Social Worker

432

Nurse Practitioner Family

650

Housing Supports

643

Pre-Vocational

641

Care Coordination

642

Supported Employment

644

Education

387

Private Vehicle

650

Housing Supports

024

Plastic Surgery

001

General Practice

019

Dentists

255

Physician Assistant

047

Chiropractor

12/16/2021

ND Medicaid Provider Taxonomy Listing-Individual

NPI

Taxonomy

Provider Type

Provider Type Description

1003829417 208G00000X 020 1003833773 208000000X 020 1003834995 207V00000X 020 1003835984 207Q00000X 020 1003837220 363A00000X 036 1003837964 207Q00000X 020 1003838590 363LF0000X 036 1003840687 2080P0207X 020 1003843574 208100000X 020 1003844648 207Q00000X 020 1003847385 2085R0202X 020 1003847971 207Q00000X 020 1003849092 208600000X 020 1003850173 208000000X 020 1003850173 2080P0204X 020 1003859117 1223S0112X 012 1003859117 1223G0001X 012 1003862756 363LG0600X 036 1003869637 208600000X 020 1003879545 207Q00000X 020 1003880733 208M00000X 020 1003880865 207RC0200X 020 1003881558 207Y00000X 020 1003881715 111N00000X 011 1003883703 207L00000X 020 1003887076 363L00000X 036 1003893355 207Y00000X 020 1003893686 207ZH0000X 020 1003893686 207ZP0101X 020 1003893686 207ZP0101X 020 1003893686 207ZP0105X 020 1003893769 207L00000X 020

Physicians Physicians Physicians Physicians Phys Assts and Advanced Nursing Provs Physicians Phys Assts and Advanced Nursing Provs Physicians Physicians Physicians Physicians Physicians Physicians Physicians Physicians Dental Providers Dental Providers Phys Assts and Advanced Nursing Provs Physicians Physicians Physicians Physicians Physicians Chiropractic Providers Physicians Phys Assts and Advanced Nursing Provs Physicians Physicians Physicians Physicians Physicians Physicians

5

Specialty Code

Specialty Description

033

Thoracic Surgery

049

Pediatrics

016

OB/GYN

173

Family Medicine

255

Physician Assistant

173

Family Medicine

432

Nurse Practitioner Family

228

Pediatric Hematology-Oncology

025

Physical Medicine and Rehab

173

Family Medicine

167

Diagnostic Radiology

173

Family Medicine

275

Surgery

049

Pediatrics

561

Pediatric Emergency Medicine; Pediatrics

212

Oral Maxillofacial Surgery

001

General Practice

551

Nurse Practitioner Gerontology

275

Surgery

173

Family Medicine

344

Hospitalist

206

Critical Care Medicine

217

Otolaryngology

047

Chiropractor

005

Anesthesiology

055

Nurse Practitioner Advanced Practice

217

Otolaryngology

560

Hematology; Pathology

436

Anatomic Pathology

022

Pathology

136

Clinical Pathology/Laboratory Medicine

005

Anesthesiology

12/16/2021

ND Medicaid Provider Taxonomy Listing-Individual

NPI

Taxonomy

Provider Type

Provider Type Description

1003894171 207L00000X 020 1003894312 208100000X 020 1003894312 2081S0010X 020 1003894338 207L00000X 020 1003901356 367500000X 036 1003902354 207X00000X 020 1003907809 207V00000X 020 1003907841 367500000X 036 1003908492 235Z00000X 023 1003913112 2084P0800X 020 1003913526 208M00000X 020 1003913898 363A00000X 036 1003914730 2084P0800X 020 1003923780 207RC0000X 020 1003928797 111N00000X 011 1003932518 103T00000X 010 1003934878 235Z00000X 023 1003963042 225X00000X 022 1003997230 207RC0200X 020 1013001114 103T00000X 010 1013001114 103TC0700X 010 1013001114 103K00000X 010 1013003540 207Q00000X 020 1013003755 207Q00000X 020 1013004969 208000000X 020 1013006253 171M00000X 017 1013006253 104100000X 010 1013006253 174400000X 010 1013008655 152W00000X 015 1013015783 208M00000X 020 1013015783 208000000X 020 1013016989 363L00000X 036

Physicians Physicians Physicians Physicians Phys Assts and Advanced Nursing Provs Physicians Physicians Phys Assts and Advanced Nursing Provs Speech Language and Hearing Svc Prov Physicians Physicians Phys Assts and Advanced Nursing Provs Physicians Physicians Chiropractic Providers Behav Health & Social Svc Prov Speech Language and Hearing Svc Prov Resp Devl Rehab and Restore Srvc Prov Physicians Behav Health & Social Svc Prov Behav Health & Social Svc Prov Behav Health & Social Svc Prov Physicians Physicians Physicians Other Service Providers Behav Health & Social Svc Prov Behav Health & Social Svc Prov Eye and Vision Service Providers Physicians Physicians Phys Assts and Advanced Nursing Provs

6

Specialty Code

Specialty Description

005

Anesthesiology

025

Physical Medicine and Rehab

548

Physical Medicine & Rehabilitation; Spor

005

Anesthesiology

341

Certified Registered Nurse Anesthetist

020

Orthopedic Surgery

016

OB/GYN

341

Certified Registered Nurse Anesthetist

272

Speech-Language Pathologist

121

Psychiatry

344

Hospitalist

255

Physician Assistant

121

Psychiatry

006

Cardiovascular Disease

047

Chiropractor

050

Psychologist

272

Speech-Language Pathologist

126

Occupational Therapy

206

Critical Care Medicine

050

Psychologist

543

Psychologist Clinical

567

Behavior Analyst

173

Family Medicine

173

Family Medicine

049

Pediatrics

335

Case Manager/Care Coordinator

625

Licensed Baccalaureate Social Worker

488

Behavior Modification Specialist

088

Optometrist

344

Hospitalist

049

Pediatrics

055

Nurse Practitioner Advanced Practice

12/16/2021

ND Medicaid Provider Taxonomy Listing-Individual

NPI

Taxonomy

Provider Type

Provider Type Description

1013016989 363LG0600X 036 1013030097 207P00000X 020 1013049683 207L00000X 020 1013053982 2080P0210X 020 1013054063 235Z00000X 023 1013057959 235Z00000X 023 1013089937 103TC0700X 010 1013089937 103T00000X 010 1013100973 208M00000X 020 1013124981 207Q00000X 020 1013125913 207T00000X 020 1013126325 101YP2500X 010 1013128222 207R00000X 020 1013128222 207RI0011X 020 1013128917 1041C0700X 010 1013131325 207XS0106X 020 1013141738 208000000X 020 1013141738 207R00000X 020 1013143346 208100000X 020 1013144401 225X00000X 022 1013144773 363LF0000X 036 1013146836 207N00000X 020 1013147263 2085R0202X 020 1013163963 207V00000X 020 1013166925 207P00000X 020 1013171800 208600000X 020 1013171800 207RC0200X 020 1013176759 207RN0300X 020 1013176759 207R00000X 020 1013178326 207Q00000X 020 1013179241 208000000X 020 1013179407 2080P0202X 020

Phys Assts and Advanced Nursing Provs Physicians Physicians Physicians Speech Language and Hearing Svc Prov Speech Language and Hearing Svc Prov Behav Health & Social Svc Prov Behav Health & Social Svc Prov Physicians Physicians Physicians Behav Health & Social Svc Prov Physicians Physicians Behav Health & Social Svc Prov Physicians Physicians Physicians Physicians Resp Devl Rehab and Restore Srvc Prov Phys Assts and Advanced Nursing Provs Physicians Physicians Physicians Physicians Physicians Physicians Physicians Physicians Physicians Physicians Physicians

7

Specialty Code

Specialty Description

551

Nurse Practitioner Gerontology

270

Emergency Medicine

005

Anesthesiology

232

Pediatric Nephrology

272

Speech-Language Pathologist

272

Speech-Language Pathologist

543

Psychologist Clinical

050

Psychologist

344

Hospitalist

173

Family Medicine

014

Neurological Surgery

190

Counselor Licensed Prof Clinical

011

Internal Medicine

188

Interventional Cardiology

191

Licensed Clinical Social Worker

214

Orthopedic Hand Surgery

049

Pediatrics

011

Internal Medicine

025

Physical Medicine and Rehab

126

Occupational Therapy

432

Nurse Practitioner Family

007

Dermatology

167

Diagnostic Radiology

016

OB/GYN

270

Emergency Medicine

275

Surgery

206

Critical Care Medicine

105

Nephrology

011

Internal Medicine

173

Family Medicine

049

Pediatrics

221

Pediatric Cardiology

12/16/2021

ND Medicaid Provider Taxonomy Listing-Individual

NPI

Taxonomy

Provider Type

Provider Type Description

1013181130 207RI0200X 020 1013205947 2085R0202X 020 1013220490 363LF0000X 036 1013220508 363LF0000X 036 1013225614 364S00000X 036 1013233436 207L00000X 020 1013242999 225100000X 022 1013250836 2080P0207X 020 1013254994 171M00000X 017 1013260850 152W00000X 015 1013270503 363L00000X 036 1013270503 363LF0000X 036 1013277987 235Z00000X 023 1013278571 106H00000X 010 1013278977 208000000X 020 1013282425 207X00000X 020 1013282524 367500000X 036 1013295260 208600000X 020 1013301217 104100000X 010 1013301217 1041C0700X 010 1013304435 225100000X 022 1013306885 2084N0402X 020 1013313535 225100000X 022 1013319193 363LN0000X 036 1013319334 363LA2200X 036 1013322387 363L00000X 036 1013322387 363LF0000X 036 1013326149 207L00000X 020 1013326149 207LC0200X 020 1013343284 363LF0000X 036 1013347186 363LF0000X 036 1013354018 363L00000X 036

Physicians Physicians Phys Assts and Advanced Nursing Provs Phys Assts and Advanced Nursing Provs Phys Assts and Advanced Nursing Provs Physicians Resp Devl Rehab and Restore Srvc Prov Physicians Other Service Providers Eye and Vision Service Providers Phys Assts and Advanced Nursing Provs Phys Assts and Advanced Nursing Provs Speech Language and Hearing Svc Prov Behav Health & Social Svc Prov Physicians Physicians Phys Assts and Advanced Nursing Provs Physicians Behav Health & Social Svc Prov Behav Health & Social Svc Prov Resp Devl Rehab and Restore Srvc Prov Physicians Resp Devl Rehab and Restore Srvc Prov Phys Assts and Advanced Nursing Provs Phys Assts and Advanced Nursing Provs Phys Assts and Advanced Nursing Provs Phys Assts and Advanced Nursing Provs Physicians Physicians Phys Assts and Advanced Nursing Provs Phys Assts and Advanced Nursing Provs Phys Assts and Advanced Nursing Provs

8

Specialty Code

Specialty Description

185

Infectious Diseases

167

Diagnostic Radiology

432

Nurse Practitioner Family

432

Nurse Practitioner Family

036

Clinical Nurse Specialist

005

Anesthesiology

123

Physical Therapist

228

Pediatric Hematology-Oncology

335

Case Manager/Care Coordinator

088

Optometrist

055

Nurse Practitioner Advanced Practice

432

Nurse Practitioner Family

272

Speech-Language Pathologist

403

Marriage & Family Therapist

049

Pediatrics

020

Orthopedic Surgery

341

Certified Registered Nurse Anesthetist

275

Surgery

425

Licensed Master Social Worker

191

Licensed Clinical Social Worker

123

Physical Therapist

522

Neurology with Spec Qual in Child Neuro

123

Physical Therapist

531

Nurse Practitioner; Neonatal

431

Nurse Practitioner Adult Health

055

Nurse Practitioner Advanced Practice

432

Nurse Practitioner Family

005

Anesthesiology

573

Anesthesiology; Critical Care Medicine

432

Nurse Practitioner Family

432

Nurse Practitioner Family

055

Nurse Practitioner Advanced Practice

12/16/2021

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