Individual provider Active NPI

Joan Quam, APRN NP

  • Adult Health Nurse Practitioner
  • Fargo, ND
National Provider Identifier
1124739263
Registry record updated Nov 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
R44324 Issued in ND
Practice address
1112 Nodak Dr S
Fargo, ND 58103-2333
Phone
(701) 232-6224
Fax
(701) 232-4687
NPI assigned
Dec 9, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X R44324 ND Primary

Addresses

Primary practice location

1112 Nodak Dr S
Fargo, ND 58103-2333

Mailing address

2401 41St St S Ste 101
Fargo, ND 58104-7783
Phone (701) 551-6980

Other practice location 1

2401 41st St S Ste 101
Fargo, ND 58104-7783
Phone (701) 551-6980

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
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 1

Enrollment IDStateProvider typePAC IDDetails
I20230201000979 ND Practitioner - Nurse Practitioner 0143691006 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
May accept Medicare assignment
Group practices
Valley Christian Counseling Center Inc 19 clinicians

Practice addresses (Care Compare)

1112 Nodak Dr S
Fargo, ND 58103-2333
Phone (701) 232-6224

Merit-based Incentive Payment System (MIPS)

Final score
83.29 of 100Reported as group
Quality
100
Improvement activities
40
Cost
44.31

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R44324NDMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Pain Medicine, P.a. CurrentSince Jan 5, 2023 Accepting new patients
Valley Christian Counseling Center Inc Adult Health CurrentSince Oct 1, 2024 Accepting new patients
Big Stone Therapies Fargo, Inc PastSince Nov 14, 2016 Accepting new patients

Locations

2401 41st St S
Ste 101
Fargo, ND 58104
Phone (701) 388-3947

2401 41st St S
Fargo, ND 58104
Phone (701) 478-7868

1112 Nodak Dr S
Fargo, ND 58103
Phone (701) 232-6224

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1670544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732579200000",
    "number": "1124739263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 41ST ST S STE 101",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581047783",
            "telephone_number": "701-551-6980",
            "fax_number": "701-551-6984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1112 NODAK DR S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581032333",
            "telephone_number": "701-232-6224",
            "fax_number": "701-232-4687"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2401 41st St S Ste 101",
            "address_purpose": "LOCATION",
            "city": "Fargo",
            "state": "ND",
            "postal_code": "581047783",
            "country_code": "US",
            "telephone_number": "701-551-6980",
            "fax_number": "701-551-6984",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QUAM",
        "first_name": "JOAN",
        "credential": "APRN NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-09",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "ND",
            "license": "R44324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.