DR. KURT ICENOGLE SR. (NPI# 1598105934) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598105934 |
| Entity Type | Individual |
| Full Name | DR. KURT ICENOGLE SR. |
| Credential | M.D. |
| Practice Address |
225 N 7th St Bismarck ND 58501-4417 |
| Mailing Address |
Po Box 5074 Sioux Falls SD 57117-5074 |
| Practice Telephone | 7013236140 |
| Practice Fax Number | 7013236907 |
| Mailing Telephone | 7013236140 |
| Mailing Fax Number | 7013236907 |
| Enumeration Date | 2013-06-30 |
| Last Update Date | 2020-06-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | 13673 | ND | Allopathic & Osteopathic Physicians |
| N | 207X00000X | Orthopaedic Surgery | BP10034047 | TX | Allopathic & Osteopathic Physicians |
| Street Address |
225 N 7TH ST |
| City | BISMARCK |
| State | ND |
| Zip Code | 58501-4417 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144240532 | Ian C Fyfe | Orthopaedic Surgery | 225 N 7th St, Bismarck, ND 58501-4417 | 2006-07-20 |
| 1861043234 | Amy Marie Keller | Family Medicine | 225 N 7th St, Bismarck, ND 58501-4417 | 2019-09-26 |
| 1265088371 | Jordan Davis | Specialist/Technologist | 225 N 7th St, Bismarck, ND 58501-4417 | 2019-08-14 |
| 1245899103 | Nadine Brew | Specialist/Technologist | 225 N 7th St, Bismarck, ND 58501-4417 | 2019-06-13 |
| 1376045245 | Doug Nickels | Specialist/Technologist | 225 N 7th St, Bismarck, ND 58501-4417 | 2018-03-06 |
| 1184132813 | Caleb Josef Balas | Physician Assistant | 225 N 7th St, Bismarck, ND 58501-4417 | 2018-01-16 |
| 1649717851 | Breann Marie Raymond | Nurse Practitioner | 225 N 7th St, Bismarck, ND 58501-4417 | 2017-01-25 |
| 1679931067 | Amanda Helm | Nurse Practitioner | 225 N 7th St, Bismarck, ND 58501-4417 | 2016-02-01 |
| 1023473725 | Kari Lynn Harris | Physical Therapist | 225 N 7th St, Bismarck, ND 58501-4417 | 2015-12-22 |
| 1447628144 | Dean Lorrie Chumley | Specialist/Technologist | 225 N 7th St, Bismarck, ND 58501-4417 | 2015-09-11 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811500911 | Sonja Lee Bosch | Counselor | 101 E. Broadway Ave Heartview Foundation, Bismarck, ND 58501 | 2020-08-28 |
| 1649740630 | Stephanie Marie Simburger | Social Worker | 3111 East Broadway Ave, Bismarck, ND 58501 | 2018-12-03 |
| 1679042519 | Prairie Rose Family Dentists | Dentist | 1110 College Dr., Suite 110, Bismark, ND 58501 | 2018-11-21 |
| 1386111276 | Arielle Joy Flynn | Genetic Counselor, MS | 414 N Seventh Street, Bismarck, ND 58501 | 2018-10-29 |
| 1164901799 | Karalee Joy Harper | Counselor | 101 E. Broadway Ave, Bismarck, ND 58501 | 2018-08-14 |
| 1518457811 | Myckenzie Saari | Behavior Technician | 1929 N Washington St., Bismarck, ND 58501 | 2018-05-14 |
| 1831687532 | Jacquelyn Mahoney | Behavioral Analyst | 604 North Ave, Bismarck, ND 58501 | 2018-04-27 |
| 1710403811 | Kayla Marie Watson | Behavior Technician | 1500 E. Capitol Ave, Suite 200, Bismarck, ND 58501 | 2017-08-21 |
| 1306368220 | Scott Vandyke | Occupational Therapist | 300 N. 7th St, Bismarck, ND 58501 | 2017-07-12 |
| 1144670019 | Bismarck Psychological Associates, Pllc | Psychologist | 107 W. Main Ave., Suite 225, Bismarck, ND 58501 | 2016-06-21 |
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| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598854085 | Raymond Gruby | Orthopaedic Surgery | 1120 College Dr Ste 100, Bismarck, ND 58501-1225 | 2006-10-12 |
| 1144240532 | Ian C Fyfe | Orthopaedic Surgery | 225 N 7th St, Bismarck, ND 58501-4417 | 2006-07-20 |
| 1750307872 | Bone & Joint Center PC | Orthopaedic Surgery | 310 N 9th St., Bismarck, ND 58501-4508 | 2006-07-14 |
| 1508842154 | Duncan B Ackerman | Orthopaedic Surgery | 310 N 9th St, Bismarck, ND 58501-4515 | 2005-12-15 |
| 1740575851 | Brock Norrie | Orthopaedic Surgery | 310 N 9th St, Bismarck, ND 58501-4515 | 2011-06-16 |
| 1659500718 | Brian Dahl | Orthopaedic Surgery | 310 N 9th Street, Bismarck, ND 58501-1397 | 2009-07-10 |
| 1538397070 | Derrick Cote | Orthopaedic Surgery | 310 N 9th Street, Bismarck, ND 58501 | 2009-06-23 |
| 1154532547 | Matthew Richard Carpenter | Orthopaedic Surgery | 225 N 7th St, Bismarck, ND 58501-4417 | 2007-05-25 |
| 1588873186 | Chad Blake Carlson | Orthopaedic Surgery | 310 N 9th St, Bismarck, ND 58501-4515 | 2007-05-21 |
| 1982796892 | Laura Marie Bruse | Orthopaedic Surgery | 225 N 7th St, Bismarck, ND 58501-4417 | 2006-09-28 |
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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.