Canopy Medical Clinic, PLLC

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

Legal business name

CANOPY MEDICAL CLINIC, PLLC

Practice address

1411 32ND St S Ste 1
Fargo, ND 58103-6304

Phone

(701) 306-0943

NPI assigned

Nov 26, 2019

Organization subpart

No

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

Authorized official

Name

Heidi Selzler-Echola, APRNNPI 1275001992

Title

Medical Director

Phone

(701) 264-5200

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ND

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Heidi Selzler-Echola, APRN

  • Obstetrics & Gynecology Nurse Practitioner
  • Fargo, ND
  • NPI 1275001992
  Medicare reassignment Care Compare group NPD Authorized official
• Tena Lorayn Prestidge

  • Mental Health Counselor
  • West Fargo, ND
  • NPI 1427787936
  Medicare reassignment Care Compare group NPD
• Valerie Rose Tweit Erickson, APRN

  • Family Nurse Practitioner
  • Bemidji, MN
  • NPI 1255782132

  ND

  Medicare reassignment Care Compare group NPD
• Kara L Gloe, LMSW

  • Clinical Social Worker
  • Moorhead, MN
  • NPI 1912572892

  ND

  Medicare reassignment NPD
• Megan P Evjen, LBSW

  • Social Worker
  • Fargo, ND
  • NPI 1194610675
  NPD
• Vianna Selene, LCSW

  • Clinical Social Worker
  • Fargo, ND
  • NPI 1871338202
  NPD
• Stephan Robert Noll

  • Mental Health Counselor
  • Fargo, ND
  • NPI 1265376131
  NPD (past)
• Michaela Kathleen Swanston, RN

  • Registered Nurse
  • Fargo, ND
  • NPI 1689526667
  NPD (past)

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

{
    "created_epoch": "1574726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736208000000",
    "number": "1386280261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 32ND ST S STE 1",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581036304",
            "telephone_number": "701-264-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 32ND ST S STE 1",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581036304",
            "telephone_number": "701-306-0943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANOPY MEDICAL CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-26",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A",
        "authorized_official_last_name": "SELZLER-ECHOLA",
        "authorized_official_first_name": "HEIDI",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "701-264-5200",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Women's Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Campbell
• Riley Campbell, PT
• Zachary Allen Campbell, PA-C
• Candid North Dakota, PLLC
• Sharon R Cannon, CRNA
• Charles C Canver, MD, MBA
• Capable Nutrition Counseling LLC
• Faith Capouch
• Joann Capouch
• Ryan Capouch, O.D.

• Women's Health Nurse Practitioner in Fargo, ND
• Providers in Fargo, ND by specialty
• Women's Health Nurse Practitioner in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.