NPIMap

Organization Active NPI

Innovis Health, LLC

  • Non-Pharmacy Dispensing Site
  • Fargo, ND
National Provider Identifier
1144710658
Registry record updated May 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
License
13699 Issued in ND
Legal business name
INNOVIS HEALTH, LLC
Practice address
4110 51St Ave S
Fargo, ND 58104-7776
Phone
(952) 653-2565
Fax
(952) 653-2540
NPI assigned
May 10, 2018
Last updated
May 10, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 10, 2018

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

Authorized official

Name
Gregory C Glasner, MD
Title
MD
Phone
(701) 364-4554

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X 13699 ND Primary

Addresses

Primary practice location

4110 51St Ave S
Fargo, ND 58104-7776

Mailing address

6501 City West Pkwy
Eden Prairie, MN 55344-3248
Phone (952) 653-2565

National Provider Directory

National Provider Directory
Tax ID family
Innovis Health8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1525910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525910400000",
    "number": "1144710658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6501 CITY WEST PKWY",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553443248",
            "telephone_number": "952-653-2565",
            "fax_number": "952-653-2540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4110 51ST AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581047776",
            "telephone_number": "952-653-2565",
            "fax_number": "952-653-2540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVIS HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-10",
        "last_updated": "2018-05-10",
        "status": "A",
        "authorized_official_last_name": "GLASNER",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "701-364-4554",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "ND",
            "license": "13699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.