Individual provider Active NPI

Jenna Sandman, APRN, CNP

  • Family Nurse Practitioner
  • Fargo, ND
National Provider Identifier
1396268074
Registry record updated Jul 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
202825 Issued in ND
Practice address
4476 31St Ave S
Fargo, ND 58104-4532
Phone
(701) 234-9400
NPI assigned
Jul 25, 2017
Last updated
Jul 27, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 202825 ND Primary

Addresses

Primary practice location

4476 31St Ave S
Fargo, ND 58104-4532

Mailing address

400 E 3Rd St
Duluth, MN 55805-1951
Phone (218) 786-8364

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
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

Enrollment IDStateProvider typePAC IDDetails
I20251029004803 ND Practitioner - Nurse Practitioner 5991294977 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of North Dakota School of Medicine, 2025
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)

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

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
202825NDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Innovis Health LLC Family Medicine CurrentSince Oct 20, 2025 Accepting new patients
Innovis Health, LLC Current Accepting new patients
Innovis Health LLC Family Medicine CurrentSince Oct 20, 2025 Accepting new patients
Dakota Home Care, Inc. PastSince Jul 1, 2022 Accepting new patients

Locations

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

3000 32nd Ave S
Fargo, ND 58103
Phone (701) 364-4222

4476 31st Ave S
Fargo, ND 58104
Phone (701) 234-9400

4476 31st Ave S
#101
Fargo, ND 58104
Phone (701) 234-9400

Organizations & group practices 4

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": "1500940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785110400000",
    "number": "1396268074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-786-8364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4476 31ST AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581044532",
            "telephone_number": "701-234-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDMAN",
        "first_name": "JENNA",
        "credential": "APRN, CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-25",
        "last_updated": "2026-07-27",
        "certification_date": "2026-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ND",
            "license": "202825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.