NPIMap

Organization Active NPI

Innovis Health LLC

Doing business as Essentia Health-Osgood Clinic

  • Multi-Specialty Clinic/Center
  • Fargo, ND
National Provider Identifier
1144776576
Registry record updated Mar 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
INNOVIS HEALTH LLC
Doing business as
Essentia Health-Osgood Clinic
Practice address
4622 40TH Ave S
Suite a
Fargo, ND 58104-4394
Phone
(701) 364-2909
NPI assigned
Aug 26, 2016
Last updated
Mar 1, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
ESSENTIA HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 1, 2024

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

Authorized official

Name
Alan J Hurley
Title
Coo
Phone
(701) 364-7667

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X NU Primary
Optometrist 152W00000X NU
Family Medicine Physician 207Q00000X NU

Addresses

Primary practice location

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

Mailing address

PO Box 1450 Nw7813
Minneapolis, MN 55485-7813
Phone (701) 364-2909

Other names 1

  • Essentia Health-Osgood Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND, MN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20071211000158 ND Part B Supplier - Clinic/Group Practice 9931298155 Receives reassigned benefits from 693 practitioners
22 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Jamestown, ND; West Fargo, ND; Wahpeton, ND; Valley City, ND; Lisbon, ND; Hankinson, ND; Fargo, ND; Bismarck, ND…
O20080115000831 MN Part B Supplier - Clinic/Group Practice 9931298155 Receives reassigned benefits from 108 practitioners
12 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Fergus Falls, MN; Wheaton, MN; Ulen, MN; Twin Valley, MN; Thief River Falls, MN; Park Rapids, MN; Moorhead, MN; Duluth, MN…

Other NPIs on the same Medicare enrollment 25

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 25

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
35D1088791Essentia Health - Osgood Clinic4622 40TH Ave S, Fargo, ND 58104Certificate of waiverSep 3, 2026

National Provider Directory

National Provider Directory

Locations

3838 San Dimas St
Ste A140
Bakersfield, CA 93301
Phone (661) 327-4647

1118 West Ave
Detroit Lakes, MN 56501
Phone (218) 847-5642

1361 Wenner Rd
Detroit Lakes, MN 56501
Phone (218) 396-6500

212 Aspen Ave NE
Menahga, MN 56464
Phone (218) 564-4131

1720 US Highway 59 SE
Thief Rvr Fls, MN 56701
Phone (218) 681-4747

110 Hillcrest Dr
Enderlin, ND 58027
Phone (701) 437-3544

1200 Harwood Dr S
Fargo, ND 58104
Phone (701) 451-4811

1711 Gold Dr S
Ste 160
Fargo, ND 58103
Phone (701) 234-9400

4476 31st Ave S
#101
Fargo, ND 58104
Phone (701) 234-9400

1021 11th St N
Wahpeton, ND 58075
Phone (701) 672-5084

Practitioners & affiliated clinicians

Practitioners 671

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 671

NPI Registry JSON

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

{
    "created_epoch": "1472169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709251200000",
    "number": "1144776576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1450 NW7813",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554857813",
            "telephone_number": "701-364-2909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4622 40TH AVE S",
            "address_2": "SUITE A",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581044394",
            "telephone_number": "701-364-2909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVIS HEALTH LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ESSENTIA HEALTH",
        "enumeration_date": "2016-08-26",
        "last_updated": "2024-03-01",
        "certification_date": "2024-03-01",
        "status": "A",
        "authorized_official_last_name": "HURLEY",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "701-364-7667"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Essentia Health-Osgood Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Mar 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.