DR. ROGER W HYNES (NPI# 1659304764) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659304764 |
| Entity Type | Individual |
| Full Name | DR. ROGER W HYNES |
| Credential | M.D. |
| Practice Address |
2101 Elm St N Fargo ND 58102-2417 |
| Practice Telephone | 7012393700 |
| Mailing Telephone | 7012393700 |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2018-02-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
4301062424 | MI | Allopathic & Osteopathic Physicians |
| N | 2085U0001X |
Radiology Specialization: Diagnostic Ultrasound |
4301062424 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | TAX ID | 381888679 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 211 S Crapo St, Suite F, Mt Pleasant, MI 488582961 | 9897732081 | 9897733418 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598978249 | Roger Jonathan Hynes | Chiropractor | 1000 Brady Street, Davenport, IA 52803-5214 | 2007-05-08 |
| Street Address |
2101 ELM ST N |
| City | FARGO |
| State | ND |
| Zip Code | 58102-2417 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437143427 | Adam John Glazier | Internal Medicine | 2101 Elm St N, Fargo, ND 58102-2417 | 2005-09-06 |
| 1235740705 | Macy Jane Schindler | Occupational Therapist | 2101 Elm St N, Fargo, ND 58102-2417 | 2020-08-10 |
| 1497363154 | Isaac Nies | Pharmacist | 2101 Elm St N, Fargo, ND 58102-2417 | 2020-07-20 |
| 1376151597 | Paul Afanasi Polanski | Social Worker | 2101 Elm St N, Fargo, ND 58102-2417 | 2020-07-14 |
| 1144848763 | Alexis Kokett | Pharmacist | 2101 Elm St N, Fargo, ND 58102-2417 | 2020-07-09 |
| 1598396459 | Leah Roethel | Dietitian, Registered | 2101 Elm St N, Fargo, ND 58102-2417 | 2020-01-30 |
| 1619508678 | Allison Wanner | Dietitian, Registered | 2101 Elm St N, Fargo, ND 58102-2417 | 2020-01-29 |
| 1720622822 | Nicole Marie Justice | Psychologist | 2101 Elm St N, Fargo, ND 58102-2417 | 2019-10-31 |
| 1750923033 | Samantha J. Tupy | Psychologist | 2101 Elm St N, Fargo, ND 58102-2417 | 2019-10-08 |
| 1639723232 | Madelyn Provost | Pharmacist | 2101 Elm St N, Fargo, ND 58102-2417 | 2019-07-31 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780285924 | Shelley Dene Townsend-hansen | Dentist | 1017 Broadway N, Fargo, ND 58102 | 2020-11-04 |
| 1275190779 | Anthony Joseph Duncan | Student in an Organized Health Care Education/Training Program | 1919 Elm Streent North, Fargo, ND 58102 | 2019-05-21 |
| 1003472317 | Sadie Marie Nelson | Nurse Practitioner | Sanford Broadway Clinic, 801 North Broadway, Fargo, ND 58102 | 2019-05-13 |
| 1124523576 | Christopher Peroutka | Specialist/Technologist | 1300 17th Ave N, Fargo, ND 58102 | 2018-03-28 |
| 1205331873 | Nathan Koens | Specialist/Technologist | 1300 17th Avenue North, Fargo, ND 58102 | 2018-03-27 |
| 1376063370 | Abby Nicole Fredrickson | Student in an Organized Health Care Education/Training Program | 1919 Elm Street North, Fargo, ND 58102 | 2017-06-21 |
| 1780118331 | Stephanie Melquist | Internal Medicine | Internal Medicine Resident Clinic, 801 N Broadway, Fargo, ND 58102 | 2017-04-19 |
| 1104215623 | Justin Lervik | Social Worker | 211 Elm St. N, 122, Fargo, ND 58102 | 2015-01-21 |
| 1770919441 | Courtney Ann Simanski | Speech-Language Pathologist | 415 4th St. N., Fargo, ND 58102 | 2013-09-25 |
| 1821431206 | Lanell Staroba | Pharmacist | 706 D 38th St, Fargo, ND 58102 | 2013-04-16 |
| Find all providers in zip 58102 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346267812 | Francisco V Ouano | Radiology | 2907 32nd St S, Fargo, ND 58103-7863 | 2006-07-17 |
| 1114942372 | Kathleen Ann Wood | Radiology | 705 13th Ave N, Apt. 310, Fargo, ND 58102-2680 | 2006-07-12 |
| 1649251224 | Martha Slade Kearns | Radiology | 23 Briarwood Pl, Fargo, ND 58104-7308 | 2005-11-09 |
| 1528062924 | Mark F Fisher | Radiology | 801 Broadway N, Fargo, ND 58102-3641 | 2005-06-13 |
| 1588078513 | Michael Samuel Lucin | Radiology | 801 Broadway N, Fargo, ND 58102-3641 | 2014-06-18 |
| 1447661285 | Tarik Nurkic | Radiology | 5225 23rd Ave S, Fargo, ND 58104-7927 | 2014-05-14 |
| 1528328754 | Matthias M Albin | Radiology | 3000 32nd Ave S, Fargo, ND 58103 | 2012-05-22 |
| 1437418993 | Safia Hope Cheeney | Radiology | 801 Broadway N, Fargo, ND 58102-3641 | 2012-05-03 |
| 1922396993 | Adam F Stibbe | Radiology | 3000 32nd Ave S, Fargo, ND 58103-6132 | 2011-07-12 |
| 1568754521 | Aaron Richard Jones | Radiology | 3000 32nd Ave S, Department of Radiology, Essentia Health, Fargo, ND 58103-6132 | 2011-05-10 |
| Find all providers in FARGO | ||||
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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.