ERIC MONTICELLO (NPI# 1558816306) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558816306 |
| Entity Type | Individual |
| Full Name | ERIC MONTICELLO |
| Credential | APRN,CNP |
| Practice Address |
1702 University Dr S Fargo ND 58103-4940 |
| Mailing Address |
400 E 3rd St Duluth MN 55805-1951 |
| Practice Telephone | 7013643300 |
| Enumeration Date | 2016-08-22 |
| Last Update Date | 2020-01-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
R38492 | ND | Allopathic & Osteopathic Physicians |
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
295229 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
R38492 | ND | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 615 Douglas St Ste 500, Durham, NC 277056616 | 9199089730 |
| 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 |
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| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841839735 | Affinitas Psychiatric Care, PC | Psychiatry & Neurology | 3523 45th St S Ste 151, Fargo, ND 58104-8962 | 2019-12-26 |
| 1134260482 | Harjinder K Virdee | Psychiatry & Neurology | 2704 N Broadway, Suite C, Fargo, ND 58102 | 2007-02-09 |
| 1821175241 | Amador Montes Dizon | Psychiatry & Neurology | 510 4th St So, Fargo, ND 58103 | 2006-11-01 |
| 1275629719 | David Javier Lopez | Psychiatry & Neurology | 300 Np Ave Ste 101, Fargo, ND 58102-4871 | 2006-10-04 |
| 1902998081 | Emmet Michael Kenney Jr. | Psychiatry & Neurology | 3201 33rd St S, Fargo, ND 58104-8823 | 2006-09-28 |
| 1093807182 | Fetih Akgul | Psychiatry & Neurology | 510 4th St South, Prairie St Johns LLC, Fargo, ND 58107 | 2006-09-28 |
| 1023111606 | Charlotte Marie Andersen | Psychiatry & Neurology | 510 4th Street S, Fargo, ND 58107 | 2006-09-07 |
| 1235156191 | Rebecca Evelyn Elbert | Psychiatry & Neurology | 3523 45th St S Ste 100, Fargo, ND 58104-8962 | 2006-07-16 |
| 1952359903 | Anne Henry Stoe | Psychiatry & Neurology | 2624 9th Ave Sw, Southeast Human Service Center, Fargo, ND 58103 | 2006-05-04 |
| 1720608110 | Natasha Lynn Isaman | Psychiatry & Neurology | 1316 23rd St S, Fargo, ND 58103-3707 | 2020-04-26 |
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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.