INNOVIS HEALTH LLC (NPI# 1780043257) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780043257 |
| Entity Type | Organization |
| Organization Name | INNOVIS HEALTH LLC |
| Other Organization Name | ESSENTIA HEALTH 52ND AVENUE CLINIC |
| Practice Address |
4110 51st Ave S Fargo ND 58104-7776 |
| Mailing Address |
Po Box 6001 Fargo ND 58108-6001 |
| Practice Telephone | 7013643100 |
| Practice Fax Number | 7013643160 |
| Mailing Telephone | 7013643100 |
| Mailing Fax Number | 7013643160 |
| Enumeration Date | 2016-02-12 |
| 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 |
|---|---|---|---|---|---|
| N | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities | ||
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Essentia Health 52nd Avenue 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 |
| 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 |
| 1437495264 | Innovis Health LLC | Family Medicine | 3902 13th Ave S, Fargo, ND 58103-3357 | 2012-12-26 |
| Street Address |
4110 51ST AVE S |
| City | FARGO |
| State | ND |
| Zip Code | 58104-7776 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114048378 | Katie Marie Bradshaw | Physical Therapist | 4110 51st Ave S, Fargo, ND 58104-7776 | 2007-04-03 |
| 1861044562 | Sarah B Hanson | Nurse Practitioner | 4110 51st Ave S, Fargo, ND 58104-7776 | 2019-07-12 |
| 1992275671 | Tiffany Amber Pickard | Nurse Practitioner | 4110 51st Ave S, Fargo, ND 58104-7776 | 2018-11-26 |
| 1811470438 | Jennifer L Henry | Nurse Practitioner | 4110 51st Ave S, Fargo, ND 58104-7776 | 2018-09-10 |
| 1154809267 | Brittney L Benson | Physician Assistant | 4110 51st Ave S, Fargo, ND 58104 | 2018-07-31 |
| 1144710658 | Innovis Health, LLC | Non-Pharmacy Dispensing Site | 4110 51st Ave S, Fargo, ND 58104-7776 | 2018-05-10 |
| 1619407327 | Kristy Ratti | Physical Therapist | 4110 51st Ave S, Fargo, ND 58104-7776 | 2017-06-14 |
| 1467985291 | Jordan I Amatuegwu | Family Medicine | 4110 51st Ave S, Fargo, ND 58104-7776 | 2017-04-08 |
| 1225576739 | Patrick Fahey | Physician Assistant | 4110 51st Ave S, Fargo, ND 58104-7776 | 2017-02-03 |
| 1003015314 | Michelle Renae Bradley | Family Medicine | 4110 51st Ave S, Fargo, ND 58104-7776 | 2007-07-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043837347 | Pinnacle Therapy & Wellness, Pllc | Physical Therapist | 4500 36th Ave S Suite 100, Fargo, ND 58104 | 2020-07-02 |
| 1619509858 | Patricia Helen Bathie | Counselor | 4243 Auburn Ave., Fargo, ND 58104 | 2020-02-05 |
| 1346892866 | Elizabeth Olis | Registered Nurse | 2633 55th St. S, Apartment 202, Fargo, ND 58104 | 2019-07-15 |
| 1780247023 | Keith Kirimi Ndege | Physical Therapy Assistant | 5225 23rd Ave South, Fargo, ND 58104 | 2019-04-22 |
| 1346728557 | Ms4 Pllc | Pharmacy | 4476 31st Avenue South, Suite #105, Fargo, ND 58104 | 2018-07-31 |
| 1891286977 | Jessica Rae Majidian | Dentist | 3030 49th St S, Fargo, ND 58104 | 2018-05-23 |
| 1821588500 | Alissa Nichole Larson | Pharmacist | 5675 26th Ave S St. 136a, Fargo, ND 58104 | 2018-05-17 |
| 1790297430 | Northern Lights Dental | Dentist | 4150 19th Ave S, Suite 301, Fargo, ND 58104 | 2017-11-03 |
| 1619406733 | Cobalt Rehabilitation Hospital Fargo LLC | Rehabilitation Hospital | 4671 38th Street S, Fargo, ND 58104 | 2017-06-12 |
| 1790210318 | Homefield Health, LLC | Clinic/Center | 4141 31st Ave S., Ste 102, Fargo, ND 58104 | 2017-04-21 |
| Find all providers in zip 58104 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790210318 | Homefield Health, LLC | Clinic/Center | 4141 31st Ave S., Ste 102, Fargo, ND 58104 | 2017-04-21 |
| 1912512419 | Naslund Counseling Services, PC | Clinic/Center | 3523 45th St S Ste 100, Fargo, ND 58104-8962 | 2020-09-10 |
| 1447896170 | Diabetes Care Clinic Pllc | Clinic/Center | 1665 43rd St S Ste 102, Fargo, ND 58103-3316 | 2019-11-18 |
| 1033751870 | Forde Counseling Services PC | Clinic/Center | 3523 45th St S Ste 100, Fargo, ND 58104-8962 | 2019-10-14 |
| 1730721796 | Pfeifer Counseling Services PC | Clinic/Center | 3523 45th St S Ste 100, Fargo, ND 58104-8962 | 2019-10-11 |
| 1437707692 | New Story Counseling Services, Pllc | Clinic/Center | 1330 Page Dr S Ste 101, Fargo, ND 58103-3551 | 2019-08-30 |
| 1285196303 | Becoming Balanced PC | Clinic/Center | 3125 41st St S, Fargo, ND 58104-8666 | 2019-04-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184181091 | Destiny Med Spa Pllc | Clinic/Center | 1415 W Dakota Pkwy Ste 3b, Williston, ND 58801-3885 | 2019-02-27 |
| 1972952034 | H.i.p.p Kids Therapy Plc | Clinic/Center | 2497 Mustang Dr S, Mandan, ND 58554-5910 | 2016-06-09 |
| 1588929004 | Northern Plains Family Medicine and Behavioral Health,p.c. | Clinic/Center | 6400 158th St Se, Menoken, ND 58558-9790 | 2012-07-10 |
| 1689852683 | Three Affiliated Tribes Parshall Health Care Center | Clinic/Center | 107 3rd St Se, Parshall, ND 58770 | 2008-02-01 |
| 1851579858 | Three Affiliated Tribes Mandaree Health Care Center | Clinic/Center | 445 #2 School Street, Mandaree, ND 58757-0000 | 2008-02-01 |
| 1558548909 | Three Affiliated Tribes White Shield Health Care Center | Clinic/Center | 2 Main Street B, Roseglen, ND 58775-0000 | 2008-01-29 |
| 1588841738 | Three Affiliated Tribes Twin Buttes Health Care Center | Clinic/Center | 726 80th Ave Nw, Halliday, ND 58636-4001 | 2008-01-29 |
| 1740473800 | Riverview Healthcare Association | Clinic/Center | 115 Vivian St, Park River, ND 58270 | 2007-08-22 |
| 1306850706 | P R Health Corporation | Clinic/Center | 115 Vivian St., Park River, ND 58270-4540 | 2006-07-28 |
| 1649226671 | Trinity Kenmare Hospital | Clinic/Center | 307 1st Ave Nw, Kenmare, ND 58746-7104 | 2006-05-25 |
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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.