Individual provider Active NPI

Christopher Eric Whited, MPAS

  • Physician Assistant
  • Fargo, ND
National Provider Identifier
1184873796
Registry record updated Dec 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PAC0524 Issued in ND
Practice address
3902 13TH Ave S
Fargo, ND 58103-3357
Phone
(701) 364-6600
Fax
(701) 364-6628
NPI assigned
Sep 18, 2008
Last updated
Dec 26, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Physician Assistant 363A00000X PAC0524 ND Primary

Addresses

Primary practice location

3902 13TH Ave S
Fargo, ND 58103-3357

Mailing address

PO Box 6001
Fargo, ND 58108-6001
Phone (701) 364-6600

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
I20140224002034 ND Practitioner - Physician Assistant 6608006374 Reassigns benefits to 2 organizations
I20190416002182 MN Practitioner - Physician Assistant 6608006374 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
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)

1401 13TH Ave E
West Fargo, ND 58078-3468
Phone (701) 364-5751

208 Oppegard Ave NW
Twin Valley, MN 56584-4038
Phone (218) 584-5181

3000 32ND Ave S
Fargo, ND 58103-6132
Phone (701) 364-8000

3902 13TH Ave S
Suite 3704
Fargo, ND 58103-7512
Phone (701) 364-6600

4110 51St Ave S
Fargo, ND 58104-7776
Phone (701) 364-3100

4476 31St Ave S
Suite 101
Fargo, ND 58104-4532
Phone (701) 234-9400

4622 40TH Ave S
Suite a
Fargo, ND 58104-4394
Phone (701) 364-8900

5 9TH Ave N
Casselton, ND 58012-3339
Phone (701) 347-4445

720 Main Ave
Moorhead, MN 56560-2752
Phone (218) 359-0399

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PAC0524NDMDPhysician Assistant
12969MNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Alexius Medical Center CurrentSince Dec 28, 2013 Accepting new patients
Innovis Health LLC CurrentSince May 23, 2014 Accepting new patients
Innovis Health LLC CurrentSince Apr 15, 2019 Accepting new patients
Innovis Health LLC CurrentSince May 23, 2014 Accepting new patients
St. Alexius Medical Center CurrentSince Dec 28, 2013 Accepting new patients

Locations

1027 Washington Ave
Detroit Lakes, MN 56501
Phone (218) 844-2300

208 Oppegard Ave NW
Twin Valley, MN 56584
Phone (218) 584-5181

900 E Broadway Ave
Bismarck, ND 58501
Phone (701) 530-7300

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

3902 13th Ave S
Fargo, ND 58103
Phone (701) 282-5880

1177 Border Ln
Washburn, ND 58577
Phone (701) 462-3396

Organizations & group practices 8

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

Hospital & facility affiliations 1

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": "1221696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451088000000",
    "number": "1184873796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6001",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581086001",
            "telephone_number": "701-364-6600",
            "fax_number": "701-364-6628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3902 13TH AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581033357",
            "telephone_number": "701-364-6600",
            "fax_number": "701-364-6628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITED",
        "first_name": "CHRISTOPHER",
        "middle_name": "ERIC",
        "name_prefix": "Mr.",
        "credential": "MPAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-18",
        "last_updated": "2015-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ND",
            "license": "PAC0524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.