Innovative Health

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

INNOVATIVE HEALTH

Practice address

340 N Main St Ste 311
Watford City, ND 58854-7308

Phone

(701) 444-2888

Fax

(701) 444-2813

NPI assigned

Mar 6, 2023

Last updated

Mar 6, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lisa Marie Sanford, FNPNPI 1740896828

Title

Nurse Practitioner

Phone

(701) 444-2888

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in ND

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lisa Marie Sanford, NP

  • Family Medicine Physician
  • Watford City, ND
  • NPI 1740896828
  Medicare reassignment Care Compare group NPD Authorized official
• Misti Breitbach, NP

  • Family Nurse Practitioner
  • Watford City, ND
  • NPI 1639627979
  Medicare reassignment Care Compare group NPD
• Jade Alexis Kelling

  • Family Nurse Practitioner
  • Watford City, ND
  • NPI 1366179509
  Medicare reassignment NPD
• Christina Jean Shockley, FNP-C, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Dickinson, ND
  • NPI 1043824501
  Medicare reassignment NPD

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

{
    "created_epoch": "1678060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678060800000",
    "number": "1437859782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1256",
            "city": "WATFORD CITY",
            "state": "ND",
            "postal_code": "588541256",
            "telephone_number": "701-444-2888",
            "fax_number": "701-444-2813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 N MAIN ST STE 311",
            "city": "WATFORD CITY",
            "state": "ND",
            "postal_code": "588547308",
            "telephone_number": "701-444-2888",
            "fax_number": "701-444-2813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-06",
        "last_updated": "2023-03-06",
        "certification_date": "2023-03-06",
        "status": "A",
        "authorized_official_last_name": "SANFORD",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "701-444-2888",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.innovativehealth.us",
            "affiliation": "N",
            "endpointDescription": "website address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "website",
            "address_1": "340 N Main St Ste 311",
            "city": "Watford City",
            "state": "ND",
            "country_code": "US",
            "postal_code": "588547308",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Chantal Helde, PHARMD, BS
• Lexyn J Henderson, DPT
• London Herbert, APRN, FNP-C
• Elizabeth Holen
• Homestead Physical Therapy PLLC
• Jackson Dodds Inc (Barrett Pharmacy)
• Logan Jangula, LCAC/LPCC
• Alexis Jade Johnsrud, MSOTR/L
• Melissa Phyllis Jones-Hjelden, OD
• Jade Alexis Kelling

• Primary Care Clinic/Center in Watford City, ND
• Providers in Watford City, ND by specialty
• Primary Care Clinic/Center in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.