Mary Omer Habib, APRN, CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

201018 Issued in ND

Practice address

4622 40TH Ave S Ste a
Fargo, ND 58104-4394

Phone

(218) 364-8900

NPI assigned

Sep 18, 2024

Last updated

Sep 18, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ND, MN2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Innovis Health LLCGroup PAC ID 9931298155, shared by 7 NPIs, 561 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ethos Home Health Home health agency, Fargo, ND, CCN 357302
• Hia Hospice Hospice, Fargo, ND, CCN 351500
• Essentia Health Hospital, Fargo, ND, CCN 350070

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Innovis Health, LLC

  dba Essentia Health Fargo

  • General Acute Care Hospital
  • Fargo, ND
  • NPI 1215125463
  Medicare reassignment NPD
• Innovis Health LLC

  dba Essentia Health Moorhead Clinic

  • Family Medicine Physician
  • Moorhead, MN
  • NPI 1659617504
  Medicare reassignment NPD
• Innovis Health LLC

  dba Essentia Health-Osgood Clinic

  • Multi-Specialty Clinic/Center
  • Fargo, ND
  • NPI 1144776576
  NPD
• Innovis Health, LLC

  dba Essentia Health The Lights West Fargo Clinic

  • Multi-Specialty Clinic/Center
  • West Fargo, ND
  • NPI 1821723610
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Bek Care, LLC

  dba Ethos Home Health

  • Home Health Agency
  • Fargo, ND
  • NPI 1043636723
  Care Compare affiliation
• Hospice of the Red River Valley

  dba HIA Hospice

  • Community Based Hospice Care Agency
  • Fargo, ND
  • NPI 1538253646
  Care Compare affiliation
• Innovis Health, LLC

  dba Essentia Health Fargo

  • General Acute Care Hospital
  • Fargo, ND
  • NPI 1215125463
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1726617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1003643487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "address_2": "SSB-6",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-786-8364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4622 40TH AVE S STE A",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581044394",
            "telephone_number": "218-364-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HABIB",
        "first_name": "MARY",
        "middle_name": "OMER",
        "credential": "APRN, CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-18",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "2529836",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ND",
            "license": "201018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Frederick Nkrumah Gyabaah, MD
• Jaclyn Haak, IBCLC
• Heather Marie Haarstad, LPN
• Alexandria Beth Haas
• Corbett A Haas, DDS,MD
• Sheikh Habibullah, MD
• Robert E Hackley Jr., DDS
• Kelly M Hadland-Betker, ATC
• Alison Haecherl, MSN, RN
• Johanna Haerter, RBT

• Family Nurse Practitioner in Fargo, ND
• Providers in Fargo, ND by specialty
• Family Nurse Practitioner in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.