RENE' D. FREDSTROM (NPI# 1326064817) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326064817 |
| Entity Type | Individual |
| Full Name | RENE' D. FREDSTROM |
| Other Name | RENE' D WENTWORTH |
| Credential | MD |
| Practice Address |
1200 S Columbia Rd - Altru Health System Grand Forks ND 58201 |
| Mailing Address |
2401 Demers Ave - Altru Business Center Grand Forks ND 58201 |
| Practice Telephone | 7017805000 |
| Practice Fax Number | 2185464400 |
| Mailing Telephone | 7017805000 |
| Mailing Fax Number | 2185464400 |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2018-11-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 11712 | ND | Allopathic & Osteopathic Physicians |
| Y | 208M00000X | Hospitalist | 11712 | ND | Allopathic & Osteopathic Physicians |
| N | 208M00000X | Hospitalist | 51353 | MN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 010290899 | 05 | |
| VA | 010290813 | 05 | |
| VA | 010290864 | 05 |
| Street Address |
1200 S COLUMBIA RD - ALTRU HEALTH SYSTEM |
| City | GRAND FORKS |
| State | ND |
| Zip Code | 58201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447644695 | Gabriel Asumeng | Internal Medicine | 1200 S Columbia Rd - Altru Health System, Grand Forks, ND 58201 | 2015-03-25 |
| 1831506716 | Kenechukwu N. Mezue | Hospitalist | 1200 S Columbia Rd - Altru Health System, Grand Forks, ND 58201 | 2014-07-12 |
| 1316101074 | Rose J. Julius | Psychiatry & Neurology | 1200 S Columbia Rd - Altru Health System, Grand Forks, ND 58201 | 2008-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255965398 | Development Homes Inc | Intermediate Care Facility, Mentally Retarded | 5509 Cottonwood Street, Grand Forks, ND 58201 | 2020-02-27 |
| 1932753779 | Lydia Pansegrau | Occupational Therapist | 2950 36th Ave S, Apt A-11, Grand Forks, ND 58201 | 2019-07-30 |
| 1407416019 | Kristina Aikens | Optometrist | 1820 S 42nd St, Grand Forks, ND 58201 | 2019-06-17 |
| 1861963209 | Jessica Kovsky | Occupational Therapist | 1375 S Columbia Rd- Altru Performance Center, Grand Forks, ND 58201 | 2018-12-11 |
| 1609345834 | Altru Specialty Services, Inc | Durable Medical Equipment & Medical Supplies | 1375 South Columbia Road, Suite A, Grand Forks, ND 58201 | 2018-11-16 |
| 1225523004 | Alicia Mae Mack | Registered Nurse | 212 S. 4th St. Suite 301, Spectra Health, Grand Forks, ND 58201 | 2018-06-25 |
| 1396260808 | Amber White | Behavior Technician | 2016 S Washington St., Grand Forks, ND 58201 | 2017-08-04 |
| 1225579840 | Kathleen Suzanne Tillman | Psychologist | 2100 S Columbia Road, Suite 202, Family Institute, PC, Grand Forks, ND 58201 | 2017-03-15 |
| 1881148906 | Melissa Pytlik Monson | Physician Assistant | 1380 S Columbia Rd - Altru Family Medcine Center, Grand Forks, ND 58201 | 2016-08-05 |
| 1477936029 | Laura Jane Carlson | Nurse Practitioner | 3165 Demers Avenue - Truyu Aesthetic Center, Grand Forks, ND 58201 | 2015-07-01 |
| Find all providers in zip 58201 | ||||
| Taxonomy Code | 208M00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Hospitalist |
| Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients. |
| Notes: Source: American Society of Hospital Medicine, 2007. http://www.hospitalmedicine.org/ [7/1/2009: definition aded] Additional Resources: Hospitalist is a recognized fellowship specialty program offered by many medical institutions. There is no board certification for the specialty at this point. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831506716 | Kenechukwu N. Mezue | Hospitalist | 1200 S Columbia Rd - Altru Health System, Grand Forks, ND 58201 | 2014-07-12 |
| 1114233038 | Hussein Somani | Hospitalist | 1200 S. Columbia Rd, Grand Forks, ND 58201 | 2010-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871979229 | Carmelia Renee Carroll | Hospitalist | 2111 Landmark Cir Nw, Minot, ND 58703-1967 | 2015-08-08 |
| 1538545918 | Dileep Kumar | Hospitalist | Sanford Health 801 Broadway N, Fargo, ND 58122-0170 | 2015-08-07 |
| 1841847688 | Renae Welhouse | Hospitalist | 300 N 7th St, Bismarck, ND 58501-4439 | 2019-08-26 |
| 1992225494 | Celestine Uche Mkpozi | Hospitalist | 3000 32nd Ave S, Fargo, ND 58103-6132 | 2017-06-26 |
| 1144740184 | Brent J Klinkhammer | Hospitalist | 3000 32nd Ave S, Fargo, ND 58103-6132 | 2017-06-21 |
| 1710410592 | Courtney Leigh Black | Hospitalist | 1 Burdick Expy W, Minot, ND 58701-4406 | 2017-04-07 |
| 1033664487 | Malik Muhammad Anwar Ul Haq | Hospitalist | 3000 32nd Ave S, Fargo, ND 58103-6132 | 2016-08-15 |
| 1912359431 | Nikolai Tolkachev | Hospitalist | 3000 32nd Avenue South, Fargo, ND 58103 | 2016-07-08 |
| 1780035543 | Kristopher Holaday | Hospitalist | 5225 23rd Ave S, Fargo, ND 58104-7927 | 2016-06-23 |
| 1629424627 | Elliot Lawrence | Hospitalist | 5225 23rd Ave S, Fargo, ND 58104-7927 | 2016-05-09 |
| Find all providers with the same taxonomy | ||||
| City | GRAND FORKS |
| Zip Code | 58201 |
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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.