Individual provider Active NPI

Mercy Oforiwaa Andoh

  • Gerontology Nurse Practitioner
  • Fargo, ND
National Provider Identifier
1275359507
Registry record updated Oct 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
201402 Issued in ND
Practice address
820 4TH St N
Fargo, ND 58102-4539
Phone
(701) 234-6161
NPI assigned
Dec 2, 2024
Last updated
Oct 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 201402 ND
Adult Health Nurse Practitioner 363LA2200X 201402 ND
Gerontology Nurse Practitioner 363LG0600X 201402 ND Primary

Addresses

Primary practice location

820 4TH St N
Fargo, ND 58102-4539

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074

Other practice location 1

1111 Highway 10 E
Detroit Lakes, MN 56501-4215
Phone (701) 356-1560

Other practice location 2

3800 56th Ave S
Fargo, ND 58104-6706
Phone (701) 356-1560

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
I20250220002832 ND Practitioner - Nurse Practitioner 3971023979 Reassigns benefits to 2 organizations
I20250923002707 MN Practitioner - Nurse Practitioner 3971023979 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Red River Valley Health Care PCGroup PAC ID 8022340637, 10 clinicians

Practice addresses (Care Compare)

1111 Hwy 10 E
Detroit Lakes, MN 56501-4215
Phone (800) 237-4629

3800 56TH Ave S
Fargo, ND 58104-6706
Phone (701) 356-1500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
201402NDMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Red River Valley Health Care PC CurrentSince Dec 11, 2025 Accepting new patients
Hospice of the Red River Valley CurrentSince Aug 5, 2025 Accepting new patients

Locations

1111 Highway 10 E
Detroit Lakes, MN 56501
Phone (701) 356-1500

1415 Madison Ave
Detroit Lakes, MN 56501
Phone (218) 844-7119

1701 38th St SW
Ste 101
Fargo, ND 58103
Phone (701) 356-1500

3800 56th Ave S
Fargo, ND 58104
Phone (701) 356-1500

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1733097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791849600000",
    "number": "1275359507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 4TH ST N",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581024539",
            "telephone_number": "701-234-6161"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1111 Highway 10 E",
            "address_purpose": "LOCATION",
            "city": "Detroit Lakes",
            "state": "MN",
            "postal_code": "565014215",
            "country_code": "US",
            "telephone_number": "701-356-1560",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3800 56th Ave S",
            "address_purpose": "LOCATION",
            "city": "Fargo",
            "state": "ND",
            "postal_code": "581046706",
            "country_code": "US",
            "telephone_number": "701-356-1560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDOH",
        "first_name": "MERCY",
        "middle_name": "OFORIWAA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-02",
        "last_updated": "2026-10-13",
        "certification_date": "2026-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ND",
            "license": "201402",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "ND",
            "license": "201402",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "ND",
            "license": "201402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.