NPIMap

Individual provider Active NPI

Christopher G Kallenbach, MD

  • Diagnostic Radiology Physician
  • Fargo, ND
National Provider Identifier
1649460551
Registry record updated Jul 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
11489 Issued in ND
Practice address
3000 32ND Ave S
Fargo, ND 58103-6132
Phone
(701) 364-8900
NPI assigned
Jul 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 01066294 IN
Diagnostic Radiology Physician 2085R0202X 4031084280 MI
Diagnostic Radiology Physician 2085R0202X 11489 ND Primary

Addresses

Primary practice location

3000 32ND Ave S
Fargo, ND 58103-6132

Mailing address

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

Other practice location 1

801 Broadway N
Fargo, ND 58102-3641
Phone (701) 234-5015

Other identifiers 2

IdentifierTypeStateIssuer
P00764117OtherINRAILROAD MEDICARE
200944030MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ckallenbach1841884@direct.sanfordhealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND, MN2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100602000198 ND Practitioner - Diagnostic Radiology 3870645492 Reassigns benefits to 1 organization
I20110629000721 MN Practitioner - Diagnostic Radiology 3870645492

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of North Dakota School of Medicine, 2004
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)

3000 32ND Ave S
Fargo, ND 58103-6132
Phone (701) 364-8000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.99 of 100Reported as group
Quality
92.39
Promoting interoperability
100
Improvement activities
40
Cost
70.9

Merit-based Incentive Payment System (MIPS)

Final score
82.73 of 100Reported as group
Quality
71.75
Promoting interoperability
100
Improvement activities
40
Cost
70.68

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4031084280MIMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Innovis Health, LLC Current Accepting new patients
Innovis Health LLC CurrentSince Jul 28, 2025 Accepting new patients
Innovis Health LLC CurrentSince Jul 28, 2025 Accepting new patients
Lisbon Area Health Services Past Accepting new patients

Locations

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

1720 US Highway 59 SE
Thief Rvr Fls, MN 56701
Phone (218) 681-4747

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

Interoperability endpoints

  • Direct secure messaging: ckallenbach1841884@direct.sanfordhealth.org

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 and National Provider Directory roles.

Hospital & facility affiliations 8

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": "1185408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753747200000",
    "number": "1649460551",
    "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": "3000 32ND AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581036132",
            "telephone_number": "701-364-8900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "801 Broadway N",
            "address_purpose": "LOCATION",
            "city": "Fargo",
            "state": "ND",
            "postal_code": "581023641",
            "country_code": "US",
            "telephone_number": "701-234-5015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KALLENBACH",
        "first_name": "CHRISTOPHER",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-26",
        "last_updated": "2025-07-29",
        "certification_date": "2025-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IN",
            "license": "01066294",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "4031084280",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "ND",
            "license": "11489",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00764117",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200944030",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ckallenbach1841884@direct.sanfordhealth.org",
            "affiliation": "N",
            "address_1": "5225 23rd Ave S",
            "city": "Fargo",
            "state": "ND",
            "country_code": "US",
            "postal_code": "581047927",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.