Individual provider Active NPI

Landi Schock, RN, PMH-NP

  • Psychiatric/Mental Health Nurse Practitioner
  • West Fargo, ND
National Provider Identifier
1184198707
Registry record updated Oct 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
200476 Issued in ND
Practice address
3220 4TH St E Ste 102
West Fargo, ND 58078-3082
Phone
(701) 501-7449
NPI assigned
Jan 16, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R30088 ND
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 200476 ND Primary

Addresses

Primary practice location

3220 4TH St E Ste 102
West Fargo, ND 58078-3082

Mailing address

2624 9TH Ave S
Fargo, ND 58103-2350
Phone (701) 298-4500

Other practice location 1

2624 9th Ave S
Fargo, ND 58103-2350
Phone (701) 298-4500

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250320004116 ND Practitioner - Nurse Practitioner 2769904531 Reassigns benefits to 1 organization
I20260218000813 MN Practitioner - Nurse Practitioner 2769904531 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3904 W Technology Cir
Suite 100
Sioux Falls, SD 57106-4200

819 30TH Ave S
Suite 206
Moorhead, MN 56560-5054

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R30088NDMDRegistered Nurse
13049MNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Mental Health Clinic PLLC Psychiatric/Mental Health CurrentSince Jan 15, 2025 Accepting new patients
Midwest Mental Health Clinic PLLC CurrentSince Jan 15, 2025 Accepting new patients

Locations

819 30th Ave S
Ste 206
Moorhead, MN 56560
Phone (218) 477-1353

1122 1st Ave N
Fargo, ND 58102
Phone (218) 477-1353

121 University Dr N
Fargo, ND 58102
Phone (218) 477-1353

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.

NPI Registry JSON

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

{
    "created_epoch": "1547596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728000000000",
    "number": "1184198707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2624 9TH AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581032350",
            "telephone_number": "701-298-4500",
            "fax_number": "701-298-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3220 4TH ST E STE 102",
            "city": "WEST FARGO",
            "state": "ND",
            "postal_code": "580783082",
            "telephone_number": "701-501-7449"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2624 9th Ave S",
            "address_purpose": "LOCATION",
            "city": "Fargo",
            "state": "ND",
            "postal_code": "581032350",
            "country_code": "US",
            "telephone_number": "701-298-4500",
            "fax_number": "701-298-4400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHOCK",
        "first_name": "LANDI",
        "credential": "RN, PMH-NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-16",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "ND",
            "license": "R30088",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ND",
            "license": "200476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Fargo, ND

Sources for this page

Verify at the official NPI Registry.