INNOVIS HEALTH LLC (NPI# 1487990339) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487990339 |
| Entity Type | Organization |
| Organization Name | INNOVIS HEALTH LLC |
| Other Organization Name | ESSENTIA HEALTH WEST FARGO CLINIC |
| Practice Address |
1401 13th Ave E West Fargo ND 58078-3468 |
| Mailing Address |
Po Box 6001 Fargo ND 58108-6001 |
| Practice Telephone | 7013645751 |
| Practice Fax Number | 7013645750 |
| Mailing Telephone | 7013643300 |
| Mailing Fax Number | 7013648906 |
| Enumeration Date | 2012-12-21 |
| Last Update Date | 2019-12-30 |
| Authorized Official Name | ALAN J HURLEY (COO) |
| Authorized Official Telephone | 7013647667 |
| Is Organization Subpart | Y |
| Parent Organization Name | ESSENTIA HEALTH MBR |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Essentia Health West Fargo Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578907267 | Innovis Health LLC | Family Medicine | 600 Water St E, Medina, ND 58467 | 2013-04-24 |
| 1164972410 | Innovis Health LLC | Family Medicine | 720 Main Ave, Moorhead, MN 56560-2752 | 2016-10-11 |
| 1790235042 | Innovis Health LLC | Family Medicine | 1517 32nd Ave S, Fargo, ND 58103-5905 | 2016-10-11 |
| 1144776576 | Innovis Health LLC | Optometrist | 4622 40th Ave S, Suite A, Fargo, ND 58104-4394 | 2016-08-26 |
| 1164978599 | Innovis Health LLC | Family Medicine | 1361 Wenner Rd, Detroit Lakes, MN 56501-7918 | 2016-08-26 |
| 1568918902 | Innovis Health LLC | Family Medicine | 1100 19th Ave N, Suite L & M, Fargo, ND 58102-5906 | 2016-08-26 |
| 1780043257 | Innovis Health LLC | Clinic/Center | 4110 51st Ave S, Fargo, ND 58104-7776 | 2016-02-12 |
| 1750725743 | Innovis Health LLC | Family Medicine | 501 Main Ave S, Hankinson, ND 58041-4108 | 2013-04-22 |
| 1114361177 | Innovis Health LLC | Family Medicine | 5 9th Ave N, Casselton, ND 58012-3339 | 2013-04-22 |
| 1578907655 | Innovis Health LLC | Family Medicine | 3000 32nd Ave S, Fargo, ND 58103-6132 | 2013-04-19 |
| Street Address |
1401 13TH AVE E |
| City | WEST FARGO |
| State | ND |
| Zip Code | 58078-3468 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639149750 | H. Katherine Kit O'neill | Psychologist | 1401 13th Ave E, West Fargo, ND 58078-3468 | 2006-01-23 |
| 1508467788 | Koree Vivatson | Nurse Practitioner | 1401 13th Ave E, West Fargo, ND 58078-3468 | 2020-11-04 |
| 1356864094 | Marjorie Masten | Nurse Practitioner | 1401 13th Ave E, West Fargo, ND 58078-3468 | 2017-07-25 |
| 1659757896 | Kathleen Bachman | Physical Therapist | 1401 13th Ave E, West Fargo, ND 58078-3468 | 2015-08-10 |
| 1558777235 | Jenna R Zaffke | Nurse Practitioner | 1401 13th Ave E, West Fargo, ND 58078-3468 | 2014-07-02 |
| 1437572534 | Robert D Dvorak | Psychologist | 1401 13th Ave E, West Fargo, ND 58078-3468 | 2014-01-24 |
| 1083056592 | Katherine M Schjeldahl | Student in an Organized Health Care Education/Training Program | 1401 13th Ave E, West Fargo, ND 58078-3468 | 2013-07-25 |
| 1720349541 | Katherine L Neubauer | Family Medicine | 1401 13th Ave E, West Fargo, ND 58078-3468 | 2012-06-07 |
| 1528355591 | Sneh N. Patel | Family Medicine | 1401 13th Ave E, West Fargo, ND 58078-3468 | 2011-06-29 |
| 1295020519 | Meghan Hampton | Preventive Medicine | 1401 13th Ave E, West Fargo, ND 58078-3468 | 2011-06-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982205068 | Ashley Kasson Therapy | Counselor | 3220 4th St E, West Fargo, ND 58078 | 2020-11-04 |
| 1427658624 | Deedee (dorin) Ngwe | Technician | 3240 9th S West Apt. 204, West Fargo, ND 58078 | 2020-10-27 |
| 1053879734 | Mpnd,inc | Pharmacy | 2050 Sheyenne Street, West Fargo, ND 58078 | 2019-03-12 |
| 1396239216 | Luke Gable | Behavior Technician | 647 13th Avenue South, West Fargo, ND 58078 | 2018-06-15 |
| 1629597919 | Cody Freng | Specialist/Technologist | 3276 9th St W Apt C, West Fargo, ND 58078 | 2017-09-18 |
| 1831613942 | Lauren Phyllis Loe | Physical Therapist | 1401 13th Avenue East, Essentia Health West Fargo Clinic, West Fargo, ND 58078 | 2017-07-31 |
| 1851746226 | Jodi Kilen | Occupational Therapy Assistant | 631 4th Ave East, West Fargo, ND 58078 | 2016-05-04 |
| 1922490101 | Betty Ann Helmer | Social Worker | 2355 Meadow Ridge Parkway, West Fargo, ND 58078 | 2015-02-25 |
| 1477972784 | Tessa Nicole Larson | Occupational Therapist | 3139 Bluestem Dr Ste 108, West Fargo, ND 58078 | 2014-04-15 |
| 1023432010 | Kaylyn Kortes | Licensed Practical Nurse | 1302 Sheyenne St, West Fargo, ND 58078 | 2014-02-11 |
| Find all providers in zip 58078 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376070581 | Steven Lee Roseno | Family Medicine | 1220 Sheyenne St, West Fargo, ND 58078-2637 | 2017-05-18 |
| 1720349541 | Katherine L Neubauer | Family Medicine | 1401 13th Ave E, West Fargo, ND 58078-3468 | 2012-06-07 |
| 1528355591 | Sneh N. Patel | Family Medicine | 1401 13th Ave E, West Fargo, ND 58078-3468 | 2011-06-29 |
| 1922391515 | Andrew Joseph Burgard | Family Medicine | 1220 Sheyenne St, West Fargo, ND 58078-2637 | 2011-05-16 |
| 1477870681 | Matthew James Mcleod | Family Medicine | 1220 Sheyenne St, West Fargo, ND 58078-2637 | 2010-04-27 |
| 1609895879 | Shanon Mark Sell | Family Medicine | 1401 13th Ave E, West Fargo, ND 58078-3468 | 2006-07-19 |
| 1801814546 | Bruce L Dahl | Family Medicine | 1220 Sheyenne St, West Fargo, ND 58078-2637 | 2006-07-18 |
| 1952329500 | David A. Jacobson | Family Medicine | 1220 Sheyenne St, West Fargo, ND 58078-2637 | 2006-07-18 |
| 1588681589 | Ronald J Borowicz | Family Medicine | 1220 Sheyenne St, West Fargo, ND 58078-2637 | 2006-07-16 |
| 1427085042 | Richard T Vetter | Family Medicine | 1401 13th Ave E, West Fargo, ND 58078-3468 | 2006-06-27 |
| Find all providers in WEST FARGO | ||||
| City | WEST FARGO |
| Zip Code | 58078 |
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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.