Amy J Hestbeck, NPC

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

R27674 Issued in ND

Practice address

2101 Elm St N
Fargo, ND 58102-2417

Phone

(701) 232-3241

NPI assigned

Apr 27, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Innovis Health LLC

  • Family Medicine Physician
  • Moorhead, MN
  • NPI 1659617504
  Medicare reassignment

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

{
    "created_epoch": "1303862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1306137195",
    "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": "701-364-4222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 ELM ST N",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581022417",
            "telephone_number": "701-232-3241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HESTBECK",
        "first_name": "AMY",
        "middle_name": "J",
        "credential": "NPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-27",
        "last_updated": "2024-12-04",
        "certification_date": "2024-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ND",
            "license": "R27674",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "CNP5060",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "ND",
            "license": "R27674",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1306137195",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "84097",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thomas L Herzog, MD
• April Ann Hess
• Aubrey Lynn Hess, PA
• Douglas James Hess, D.O.
• Natalie Marie Roberts Hest, MT-BC/L
• Mallory Hestdalen
• Allison Laura Hetland, DO
• Dennis Lynn Hetland, DDS
• Brianna Hettwer, PHARMD, RPH
• Brittany Kathleen Heuer

• Gerontology Nurse Practitioner in Fargo, ND
• Providers in Fargo, ND by specialty
• Gerontology Nurse Practitioner in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.