JEENA EASOW (NPI# 1225264104) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225264104 |
| Entity Type | Individual |
| Full Name | JEENA EASOW |
| Credential | M.D. |
| Practice Address |
5225 23rd Ave S Fargo ND 58104-7927 |
| Mailing Address |
725 Albany St 3rd Floor, Suite A Boston MA 02118-2526 |
| Practice Telephone | 7014172575 |
| Practice Fax Number | 7014172535 |
| Mailing Telephone | 6174144861 |
| Enumeration Date | 2009-06-05 |
| Last Update Date | 2019-10-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | 241581 | MA | Allopathic & Osteopathic Physicians |
| Y | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
15865 | ND | Allopathic & Osteopathic Physicians |
| Street Address |
5225 23RD AVE S |
| City | FARGO |
| State | ND |
| Zip Code | 58104-7927 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730141466 | Edgardo Abad Crisostomo | Psychiatry & Neurology | 5225 23rd Ave S, Fargo, ND 58104 | 2006-04-06 |
| 1881295814 | Kelsey Kincaid | Dietitian, Registered | 5225 23rd Ave S, Fargo, ND 58104-7927 | 2020-11-05 |
| 1598365819 | Hannah Muehlberg | Occupational Therapist | 5225 23rd Ave S, Fargo, ND 58104-7927 | 2020-10-27 |
| 1174120281 | Sanford Medical Center Fargo | Pharmacy | 5225 23rd Ave S, Fargo, ND 58104-7927 | 2020-10-02 |
| 1932714169 | Ashraf Al-tarifi | Internal Medicine | 5225 23rd Ave S, Fargo, ND 58104-7927 | 2020-09-14 |
| 1821609116 | Heidi Nelson | Occupational Therapist | 5225 23rd Ave S, Fargo, ND 58104-7927 | 2020-08-11 |
| 1689284671 | Lindsay Raye Busse | Nurse Practitioner | 5225 23rd Ave S, Fargo, ND 58104-7927 | 2020-08-04 |
| 1356950752 | Jordan Mallery | Internal Medicine | 5225 23rd Ave S, Fargo, ND 58104-7927 | 2020-07-31 |
| 1093324014 | Dalton James Peaslee | Internal Medicine | 5225 23rd Ave S, Fargo, ND 58104-7927 | 2020-07-27 |
| 1285243543 | Mathew Gerving | Internal Medicine | 5225 23rd Ave S, Fargo, ND 58104-7927 | 2020-07-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043837347 | Pinnacle Therapy & Wellness, Pllc | Physical Therapist | 4500 36th Ave S Suite 100, Fargo, ND 58104 | 2020-07-02 |
| 1619509858 | Patricia Helen Bathie | Counselor | 4243 Auburn Ave., Fargo, ND 58104 | 2020-02-05 |
| 1346892866 | Elizabeth Olis | Registered Nurse | 2633 55th St. S, Apartment 202, Fargo, ND 58104 | 2019-07-15 |
| 1780247023 | Keith Kirimi Ndege | Physical Therapy Assistant | 5225 23rd Ave South, Fargo, ND 58104 | 2019-04-22 |
| 1346728557 | Ms4 Pllc | Pharmacy | 4476 31st Avenue South, Suite #105, Fargo, ND 58104 | 2018-07-31 |
| 1891286977 | Jessica Rae Majidian | Dentist | 3030 49th St S, Fargo, ND 58104 | 2018-05-23 |
| 1821588500 | Alissa Nichole Larson | Pharmacist | 5675 26th Ave S St. 136a, Fargo, ND 58104 | 2018-05-17 |
| 1790297430 | Northern Lights Dental | Dentist | 4150 19th Ave S, Suite 301, Fargo, ND 58104 | 2017-11-03 |
| 1619406733 | Cobalt Rehabilitation Hospital Fargo LLC | Rehabilitation Hospital | 4671 38th Street S, Fargo, ND 58104 | 2017-06-12 |
| 1790210318 | Homefield Health, LLC | Clinic/Center | 4141 31st Ave S., Ste 102, Fargo, ND 58104 | 2017-04-21 |
| Find all providers in zip 58104 | ||||
| Taxonomy Code | 2086S0122X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Plastic and Reconstructive Surgery |
| A surgeon who specializes in plastic and reconstructive surgery. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619273927 | Avera St. Luke's | Surgery | 4141 31st Ave S Ste 105, Fargo, ND 58104-8778 | 2011-02-03 |
| 1669708129 | Diane R Schmidt-krings Md PC | Surgery | 3270 20th St S, Fargo, ND 58104-5917 | 2009-10-19 |
| 1255534871 | Ha Chim | Surgery | 2801 University Dr S, Fargo, ND 58103-6029 | 2007-06-10 |
| 1700907912 | Lamb Plastic Surgery Center PC | Surgery | 1507 South University Drive, Fargo, ND 58103 | 2007-04-03 |
| 1639259310 | Jeffrey R Keim | Surgery | 2801 University Dr S, Fargo, ND 58103-6029 | 2006-10-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184720948 | D'arcy Adaire Honeycutt | Surgery | 810 E Rosser Ave, Suite 303, Bismarck, ND 58501-4463 | 2006-09-16 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.