INNOVIS HEALTH (NPI# 1083756142) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083756142 |
| Entity Type | Organization |
| Organization Name | INNOVIS HEALTH |
| Other Organization Name | INNOVIS HEALTH - SOUTH UNIVERSITY |
| Practice Address |
1702 University Dr S Fargo ND 58103-4940 |
| Mailing Address |
5626 Oberlin Dr Suite 110 San Diego CA 92121-1705 |
| Practice Telephone | 7013643300 |
| Mailing Telephone | 8586252990 |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2012-10-16 |
| Authorized Official Name | MR. KENNY HEINE (DIRECTOR OF OPERATIONS) |
| Authorized Official Telephone | 8586252990 |
| Is Organization Subpart | Y |
| Parent Organization Name | MEDVANTX, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332900000X | Non-Pharmacy Dispensing Site | 5109 | ND | Suppliers |
| Other Name | Type Code |
|---|---|
| Innovis Health - South University | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336318567 | Innovis Health | Non-Pharmacy Dispensing Site | 3000 32nd Ave Sw, Fargo, ND 58103-6132 | 2008-02-21 |
| Street Address |
1702 UNIVERSITY DR S |
| City | FARGO |
| State | ND |
| Zip Code | 58103-4940 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245223023 | Kimberly Rae Kelly | Dermatology | 1702 University Dr S, Fargo, ND 58103-4940 | 2005-08-26 |
| 1467060046 | Jessica Marie Munro | Optometrist | 1702 University Dr S, Fargo, ND 58103-4940 | 2020-07-20 |
| 1972132249 | Kalee Irene Wysuph | Student in an Organized Health Care Education/Training Program | 1702 University Dr S, Fargo, ND 58103-4940 | 2020-04-07 |
| 1699314617 | April M Sweet | Nurse Practitioner | 1702 University Dr S, Fargo, ND 58103-4940 | 2019-12-23 |
| 1427603588 | Annelise Sterneman | Nurse Practitioner | 1702 University Dr S, Fargo, ND 58103-4940 | 2019-08-06 |
| 1518511799 | Morgan A Schmitz | Nurse Practitioner | 1702 University Dr S, Fargo, ND 58103-4940 | 2019-07-26 |
| 1093367799 | Josalyn J Grueneich | Nurse Practitioner | 1702 University Dr S, Fargo, ND 58103-4940 | 2019-07-12 |
| 1295395176 | Amanda J Coronato | Occupational Therapist | 1702 University Dr S, Fargo, ND 58103-4940 | 2019-06-13 |
| 1962976068 | Moriah M Anderson | Dietitian, Registered | 1702 University Dr S, Fargo, ND 58103-4940 | 2019-01-11 |
| 1811489743 | Karli Lenae Roman | Nurse Practitioner | 1702 University Dr S, Fargo, ND 58103-4940 | 2018-06-06 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659924843 | Amanda Hericks | Dentist | 1338 Gateway Drive S, Fargo, ND 58103 | 2019-07-17 |
| 1285298240 | Ann Louise Breen | Optometrist | Sanford Southpointe Eye Center & Optical, 2400 32nd Ave. S., Fargo, ND 58103 | 2019-04-25 |
| 1245706597 | Lisa Elaine Livingston | Counselor | 1337 14 and Half St. S., Fargo, ND 58103 | 2018-10-15 |
| 1528569662 | Misty Lynn Hagen | Counselor | 901 28th St. South, Suite B, Fargo, ND 58103 | 2018-02-23 |
| 1083133011 | Faith Homecare Professionals LLC | Home Health | 304 25th St S, Suite B, Fargo, ND 58103 | 2017-09-11 |
| 1982138749 | Matthew Troyer | Pharmacist | 2425 13th Ave, Fargo, ND 58103 | 2017-04-18 |
| 1801338504 | Amy Nguyen Christianson | Chiropractor | 1650 45th St S Ste 113, Fargo, ND 58103 | 2016-11-11 |
| 1245772359 | Andrea Marie Hanson | Nurse Practitioner | 2400 32nd Ave South, Fargo, ND 58103 | 2016-11-07 |
| 1831647940 | Abigail Carmen Burkett Vetter | Nurse Practitioner | 2928 University Dr S Suite 101, Fargo, ND 58103 | 2016-09-18 |
| 1013361302 | Nancy Knowlton | Speech-Language Pathologist | 3001 11th Ave S, Beyond Boundaries Speech-language, Fargo, ND 58103 | 2016-04-22 |
| Find all providers in zip 58103 | ||||
| Taxonomy Code | 332900000X |
| Grouping | Suppliers |
| Classification | Non-Pharmacy Dispensing Site |
| A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275675118 | Internal Medicine Associates, Ltd. | Non-Pharmacy Dispensing Site | 1707 Gold Dr S, Suite 101, Fargo, ND 58103-6413 | 2007-02-13 |
| 1144710658 | Innovis Health, LLC | Non-Pharmacy Dispensing Site | 4110 51st Ave S, Fargo, ND 58104-7776 | 2018-05-10 |
| 1073867263 | Hans Bjellum Md PC | Non-Pharmacy Dispensing Site | 1100 19th Ave N, Fargo, ND 58102-5906 | 2012-11-09 |
| 1679869697 | Hans Bjellum, Md, PC | Non-Pharmacy Dispensing Site | 4622 40th Ave S, Fargo, ND 58104-4394 | 2011-06-28 |
| 1104112127 | Hans Bjellum, Md, PC | Non-Pharmacy Dispensing Site | 1517 32nd Ave S, Fargo, ND 58103-5905 | 2011-06-28 |
| 1336318567 | Innovis Health | Non-Pharmacy Dispensing Site | 3000 32nd Ave Sw, Fargo, ND 58103-6132 | 2008-02-21 |
| 1881736940 | Sutter Health | Non-Pharmacy Dispensing Site | 3902 13th Ave S, Fargo, ND 58103-3357 | 2007-02-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700444619 | St Alexius Medical Center | Non-Pharmacy Dispensing Site | 807 East Main Suite A, Bismarck, ND 58503 | 2019-06-05 |
| 1437717576 | St Alexius Medical Center | Non-Pharmacy Dispensing Site | 921 W Interstate Ave, Bismarck, ND 58503-0955 | 2019-06-04 |
| 1548870520 | Mckenzie County Healthcare Systems Inc | Non-Pharmacy Dispensing Site | 709 4th Ave Ne, Watford City, ND 58854-7628 | 2020-08-05 |
| 1538727441 | St Alexius Medical Center | Non-Pharmacy Dispensing Site | 4315 Ottawa St, Bismarck, ND 58503 | 2019-06-05 |
| 1225433485 | St Josephs Hospital and Health Center | Non-Pharmacy Dispensing Site | 30 7th St W, Dickinson, ND 58601-4335 | 2014-10-30 |
| 1457629834 | Altru Health System | Non-Pharmacy Dispensing Site | 1200 S Columbia Rd, Grand Forks, ND 58201-4036 | 2011-12-13 |
| 1790060937 | Mercy Medical Center | Non-Pharmacy Dispensing Site | 1301 15th Ave W, Williston, ND 58801-3821 | 2011-10-19 |
| 1851691596 | Trinity Hospitals | Non-Pharmacy Dispensing Site | 1 Burdick Expy W, Minot, ND 58701-4406 | 2010-10-28 |
| 1508182684 | P R Health Corporation | Non-Pharmacy Dispensing Site | 115 Vivian St W, Park River, ND 58270-4540 | 2010-04-14 |
| 1174662852 | Altru Family Medicine Center | Non-Pharmacy Dispensing Site | 1380 S Columbia Rd, Grand Forks, ND 58201-4059 | 2007-02-06 |
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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.