CHI Health Connect at Home-Fargo
Organization Active NPI Community Based Hospice Care Agency · Williston, ND
NPI 1639484140 · NPPES record last updated Feb 12, 2026
Key facts
- NPI
- 1639484140
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community Based Hospice Care Agency 251G00000X
- Legal business name
- CHI HEALTH CONNECT AT HOME-FARGO
- Practice address
- 1301 15TH Ave W
Williston, ND 58801-3821 - Phone
- (701) 774-7430
- Fax
- (701) 774-7465
- NPI assigned
- Aug 10, 2010
- Organization subpart
- Yes
- Parent organization (as reported)
- COMMONSPIRIT HEALTH
Authorized official
- Name
- Nicole Peyerl
- Title
- Director Operations/Auth Official
- Phone
- (701) 238-3206
Owners & managing parties with NPI records 1
-
Laura Archuleta, M.D.
Other NPIs with the same Medicare PAC ID 11
Corporate family (same tax ID) 17
Practitioners 2
-
Stacie Cleveland, FNP-C
-
Michelle A Cooley, NP-C
Affiliated clinicians 4
-
Laura Archuleta, M.D.
-
Robert G. Kemp, M.D.
-
Bruce S. Pugatch, MD
-
Ryan M Siewert, MD
Medicare Care Compare: Hospice
- Listed as
- CHI Health at Home - Hospice
- Ownership
- Non-Profit
- Certified
- Feb 20, 1991
- Medicare certification status
- Active
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ND
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
- Corporation · Non-profit
- Incorporated
- Feb 10, 2010 in MN
- Enrollment address
- 1301 15TH Ave W
Williston, ND 58801-3821
All disclosed owners & managing parties 9
| Name | Role | Since | Share |
|---|---|---|---|
| Commonspirit Health |
5% Or Greater Direct Ownership Interest | Dec 26, 2010 | 100% |
| Wendy L McGinley |
Corporate Officer |
Jan 1, 2023 | |
| Laura J Archuleta |
Contracted Managing Employee |
Jan 1, 2023 | |
| Nicole a Peyerl |
Corporate Officer |
Oct 1, 2021 | |
| W-2 Managing Employee |
Oct 1, 2021 | ||
| Gretchen K Dobervich |
Corporate Director |
Jan 1, 2018 | |
| Mary Quandt |
Corporate Director |
Jul 1, 2025 | |
| Caroline Stoltz |
Corporate Director |
Jul 1, 2025 | |
| Lance W Gulleson |
Corporate Director |
Jul 1, 2018 | |
| Gloria a Dohman |
Corporate Director |
Jul 1, 2017 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20101130000422 | ND | Part a Provider - Hospice | 4789870924 | Practice locations: Williston, ND |
National Provider Directory
- Tax ID family
- CHI Health Connect at Home
- Part of
- Catholic Health Initiatives
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | ND | Yes |
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 identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6010 | Medicaid | ND |
Other names
- CHI Health at Home
Other providers in Williston, ND
- Robert G Ceynar
- Mia Charles
- Chatter Pediatric Walk-in Clinic
- Chatter, LLC
- CHI Health Connect at Home-Fargo
- Choice Recovery Counseling, PLLC
- Chelsea Rose Christie
- Therresa Christopherson
- City of Williston
- City of Williston
All providers in Williston, ND · Community Based Hospice Care Agency in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 12, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.