Individual provider Active NPI

Hillary M Newborg, APRN,CNP

  • Family Nurse Practitioner
  • Lisbon, ND
National Provider Identifier
1154091916
Registry record updated Oct 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R39053 Issued in ND
Practice address
819 Main St
Lisbon, ND 58054-4244
Phone
(701) 693-4134
NPI assigned
Sep 14, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R39053 ND Primary
Registered Nurse 163W00000X R39053 ND

Addresses

Primary practice location

819 Main St
Lisbon, ND 58054-4244

Mailing address

1702 University Dr S
Fargo, ND 58103-4940
Phone (701) 364-8000

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
I20211013002340 ND Practitioner - Nurse Practitioner 6901204452 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Innovis Health LLCGroup PAC ID 9931298155, 561 clinicians

Practice addresses (Care Compare)

819 Main St
Lisbon, ND 58054-4244
Phone (701) 683-4134

Hospital & facility affiliations

  • Essentia Health Hospital, Fargo, ND, CCN 350070
  • Lisbon Area Health Services Hospital, Lisbon, ND, CCN 351311

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R39053NDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Innovis Health LLC CurrentSince Nov 22, 2021 Accepting new patients
Innovis Health, LLC Current Accepting new patients

Locations

3000 32nd Ave S
Fargo, ND 58103
Phone (701) 364-3000

1702 University Dr S
Fargo, ND 58103
Phone (701) 364-4222

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1631577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633564800000",
    "number": "1154091916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1702 UNIVERSITY DR S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581034940",
            "telephone_number": "701-364-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "819 MAIN ST",
            "city": "LISBON",
            "state": "ND",
            "postal_code": "580544244",
            "telephone_number": "701-693-4134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWBORG",
        "first_name": "HILLARY",
        "middle_name": "M",
        "credential": "APRN,CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-14",
        "last_updated": "2021-10-07",
        "certification_date": "2021-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ND",
            "license": "R39053",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "ND",
            "license": "R39053",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lisbon, ND

Sources for this page

Verify at the official NPI Registry.