Michelle R Bradley (NPI# 1003015314, PAC ID# 3678619020) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1003015314 |
| PAC ID by PECOS | 3678619020 |
| Professional Enrollment ID | I20170706002896 |
| Full Name | Michelle R Bradley |
| Organization Legal Name | INNOVIS HEALTH, LLC |
| Address |
4110 51st Ave S Fargo ND 58104-7776 |
| Phone Number | 7013643100 |
| Gender | F |
| Medical School | LAKE ERIE COLLEGE OF OSTEOPATHIC MEDICINE |
| Graduation Year | 2004 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 9931298155 |
| Number of Group Practice Members | 371 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 350070 | ESSENTIA HEALTH |
| Address | Phone | Organization |
|---|---|---|
| 4110 51st Ave S, Fargo, ND 58104-7776 | 7013643100 | INNOVIS HEALTH, LLC |
| Organization Legal Name | INNOVIS HEALTH, LLC |
| Physicians | 358 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kyrie Marie Severson | Nurse Practitioner | Innovis Health, LLC | 4622 40th Ave S, Suite A, Fargo, ND 58104-4394 |
| Holli Marquart | Nurse Practitioner | Innovis Health, LLC | 2430 20th St Sw, Jamestown, ND 58401-6201 |
| Taylor G Mertz | Family Medicine | Innovis Health, LLC | 801 Belsly Blvd, Moorhead, MN 56560-5055 |
| Bonita J Jenzen | Nurse Practitioner | Innovis Health, LLC | 501 Main Ave S, Hankinson, ND 58041-4108 |
| Zena K Homan | Obstetrics/gynecology | Innovis Health, LLC | 3000 32nd Ave S, Fargo, ND 58103-6132 |
| Daniel J Levin | Optometry | Innovis Health, LLC | 1100 19th Ave N, Suite Landm, Fargo, ND 58102-5906 |
| Brian K Cooper | Physician Assistant | Innovis Health, LLC | 275 11th St S, Wahpeton, ND 58075-4655 |
| Joel Ross Haugen | Family Medicine | Innovis Health, LLC | 5 9th Ave N, Casselton, ND 58012-3339 |
| Hans E Bjellum | Family Medicine | Innovis Health, LLC | 720 Main Ave, Moorhead, MN 56560-2752 |
| Susan C Nordquist | Nurse Practitioner | Innovis Health, LLC | 3902 13 Ave S, Fargo, ND 58103-3357 |
| Street Address |
4110 51ST AVE S |
| City | FARGO |
| State | ND |
| Zip | 58104-7776 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Roberta J Solberg | Nurse Practitioner | Innovis Health, LLC | 4110 51st Ave S, Fargo, ND 58104-7776 |
| Sreejith Gopi | General Practice | Innovis Health, LLC | 4110 51st Ave S, Fargo, ND 58104-7776 |
| Jack T Baden | Nurse Practitioner | Innovis Health, LLC | 4110 51st Ave S, Fargo, ND 58104-7776 |
| Kayla Joy Thompson | Nurse Practitioner | Innovis Health, LLC | 4110 51st Ave S, Fargo, ND 58104-7776 |
| Michael J Blankinship | Dermatology | Innovis Health, LLC | 4110 51st Ave S, Fargo, ND 58104-7776 |
| Mykell M Barnacle | Nurse Practitioner | Innovis Health, LLC | 4110 51st Ave S, Fargo, ND 58104-7776 |
| Sarah B Hanson | Nurse Practitioner | Innovis Health, LLC | 4110 51st Ave S, Fargo, ND 58104-7776 |
| David Hartson | Psychologist, Clinical | Innovis Health, LLC | 4110 51st Ave S, Fargo, ND 58104-7776 |
| Tiffany Ann Pickard | Nurse Practitioner | Innovis Health, LLC | 4110 51st Ave S, Fargo, ND 58104-7776 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Parth A Vyas | Orthopedic Surgery | Sanford Medical Center Fargo | 2301 25th St S, Fargo, ND 58104 |
| Breana B Ritchie | Nurse Practitioner | Sanford Medical Center Fargo | 2301 25th St S, Fargo, ND 58104 |
| Glenda G Trochmann | Clinical Social Worker | Deer Oaks Mental Health Associates PC | 201 S University Dr, Fargo, ND 58104-1775 |
| Su Ann Ng | Diagnostic Radiology | Medical Imaging of Lehigh Valley PC | 4222 Clubhouse Dr S, Fargo, ND 58104-3332 |
| Martha Slade Kearns | Diagnostic Radiology | Medical Imaging of Lehigh Valley PC | 4222 Clubhouse Dr S, Fargo, ND 58104-3332 |
| Crystal R Wring | Physical Therapy | Caring Edge Op LLC | 4420 37th Ave S, Fargo, ND 58104-3400 |
| Sarah Coplin | Physical Therapy | Caring Edge Op LLC | 4420 37th Ave S, Fargo, ND 58104-3400 |
| Marcus Anthony Sickler | Occupational Therapy | Caring Edge Op LLC | 4420 37th Ave S, Fargo, ND 58104-3400 |
| Mckayla M Artz | Physical Therapy | Horizon Therapy, Inc. | 4420 37th Ave S, Fargo, ND 58104-3400 |
| Alyssa J Shirek | Occupational Therapy | Horizon Therapy, Inc. | 4420 37th Ave S, Fargo, ND 58104-3400 |
| Find all physicians in zip 58104 | |||
| City | FARGO |
| Zip Code | 58104 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | FARGO + FAMILY MEDICINE |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.