Individual provider Active NPI

Christopher Sue, MD

  • Family Medicine Physician
  • Wahpeton, ND
National Provider Identifier
1639730799
Registry record updated Aug 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
18008 Issued in ND
Practice address
275 11TH St S
Wahpeton, ND 58075-4655
Phone
(701) 642-2000
NPI assigned
Jun 27, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 74223-20 WI
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 18008 ND Primary

Addresses

Primary practice location

275 11TH St S
Wahpeton, ND 58075-4655

Mailing address

1702 University Dr S
Fargo, ND 58103-4940

Other practice location 1

2400 W Villard Ave
Milwaukee, WI 53209-4901
Phone (414) 527-8191

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220819000529 ND Practitioner - Family Practice 0547674657 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2019
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)

275 11TH St S
Wahpeton, ND 58075-4655
Phone (701) 642-2000

Hospital & facility affiliations

  • Essentia Health Hospital, Fargo, ND, CCN 350070
  • St Francis Medical Center Hospital, Breckenridge, MN, CCN 241377

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
18008NDMDFamily Medicine Physician
74223-20WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Innovis Health LLC Family Medicine CurrentSince Aug 15, 2022 Accepting new patients
Innovis Health, LLC. Family Medicine CurrentSince Aug 15, 2022 Accepting new patients
Innovis Health, LLC Current Accepting new patients

Locations

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

1702 University Dr S
Fargo, ND 58103
Phone (701) 364-4222

275 11th St S
Wahpeton, ND 58075
Phone (701) 642-2000

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1561593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659830400000",
    "number": "1639730799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1702 UNIVERSITY DR S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581034940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 11TH ST S",
            "city": "WAHPETON",
            "state": "ND",
            "postal_code": "580754655",
            "telephone_number": "701-642-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2400 W Villard Ave",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532094901",
            "country_code": "US",
            "telephone_number": "414-527-8191",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUE",
        "first_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-27",
        "last_updated": "2022-08-07",
        "certification_date": "2022-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "74223-20",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ND",
            "license": "18008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wahpeton, ND

Sources for this page

Verify at the official NPI Registry.