NPIMap

Organization Active NPI

CHI Health Connect at Home-Fargo

Doing business as CHI Health at Home

  • Community Based Hospice Care Agency
  • Williston, ND
National Provider Identifier
1639484140
Registry record updated Feb 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
CHI HEALTH CONNECT AT HOME-FARGO
Doing business as
CHI Health at Home
Practice address
1301 15TH Ave W
Williston, ND 58801-3821
Phone
(701) 774-7430
Fax
(701) 774-7465
NPI assigned
Aug 10, 2010
Last updated
Feb 12, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
COMMONSPIRIT HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 12, 2026

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

Authorized official

Name
Nicole Peyerl
Title
Director Operations/Auth Official
Phone
(701) 238-3206

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X ND Primary

Addresses

Primary practice location

1301 15TH Ave W
Williston, ND 58801-3821

Mailing address

4265 45TH St S Ste 200
Fargo, ND 58104-4309
Phone (701) 237-8116

Other names 1

  • CHI Health at Home Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101130000422 ND Part A Provider - Hospice 4789870924 Practice locations: Williston, ND

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1639484140. Details of each certification follow.

Hospice certification: CCN 351505

Legal name
CHI HEALTH CONNECT AT HOME - FARGO
Doing business as
CHI HEALTH AT HOME
Certification status
Active
Provider type (POS)
Hospice
Participating since
Feb 20, 1991
Last certification
Mar 10, 2022
Ownership / control type
Non-Profit - Other
Organization structure
CorporationNon-profit
Incorporated
Feb 10, 2010 in MN
Enrollment address
1301 15TH Ave W
Williston, ND 58801-3821

Other NPIs with the same Medicare PAC ID 11

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospice

Medicare Care Compare
Listed as
CHI Health at Home - HospiceCCN 351505 · All quality measures
Ownership
Non-Profit
Certified
Feb 20, 1991
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
CHI Health Connect at Home18 organizations share this tax ID, including this one
Part of
Catholic Health Initiatives

Other organizations with this tax ID 17

Organizations that report the same tax identification number in the National Provider Directory.

View all 17

Ownership & related parties

All disclosed owners & managing parties 9

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Commonspirit Health Organization, Englewood, CO Corporation, Non-profit 5% Or Greater Direct Ownership Interest Dec 26, 2010 100%
Wendy L McGinley Individual Corporate OfficerBoard Chair Jan 1, 2023
Laura J Archuleta Individual Contracted Managing EmployeeMD; Jan 1, 2023
Nicole a Peyerl Individual Corporate OfficerMarket Vice President of Operations Oct 1, 2021
W-2 Managing EmployeeAd; Oct 1, 2021
Gretchen K Dobervich Individual Corporate DirectorBoard Member Jan 1, 2018
Mary Quandt Individual Corporate DirectorBoard Member Jul 1, 2025
Caroline Stoltz Individual Corporate DirectorBoard Member Jul 1, 2025
Lance W Gulleson Individual Corporate DirectorBoard Member Jul 1, 2018
Gloria a Dohman Individual Corporate DirectorBoard Member Jul 1, 2017

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Affiliated clinicians 4

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1281398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770854400000",
    "number": "1639484140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4265 45TH ST S STE 200",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581044309",
            "telephone_number": "701-237-8116",
            "fax_number": "701-237-8188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 15TH AVE W",
            "city": "WILLISTON",
            "state": "ND",
            "postal_code": "588013821",
            "telephone_number": "701-774-7430",
            "fax_number": "701-774-7465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHI HEALTH CONNECT AT HOME-FARGO",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMONSPIRIT HEALTH",
        "enumeration_date": "2010-08-10",
        "last_updated": "2026-02-12",
        "certification_date": "2026-02-12",
        "status": "A",
        "authorized_official_last_name": "PEYERL",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "DIRECTOR OPERATIONS/AUTH OFFICIAL",
        "authorized_official_telephone_number": "701-238-3206"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "ND",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHI Health at Home",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CHI Health at Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Williston, ND

Sources for this page

Verify at the official NPI Registry.