Active NPI
Haley Faye Wahl
- Family Nurse Practitioner
- Fargo, ND
National Provider Identifier
1669017265
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- R42177
- Practice address
- 3000 32ND Ave S
Fargo, ND 58103-6132 - Phone
- (218) 786-8364
- NPI assigned
- Nov 7, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | R42177 | ND | |
| Family Nurse Practitioner | 363LF0000X | R42177 | 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
2400 32nd Ave S
Fargo, ND 58103-5800
Phone (701) 234-2000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ND, MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200529000236 | ND | Practitioner - Nurse Practitioner | 7618398694 | Reassigns benefits to 2 organizations |
| I20231012003249 | MN | Practitioner - Nurse Practitioner | 7618398694 |
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3000 32ND Ave S
Fargo, ND 58103-6132
Phone (701) 364-8000
Hospital & facility affiliations
- Essentia Health
- Essentia Health St Marys - Detroit Lakes
- Essentia Health Fosston
- Essentia Health Ada
Merit-based Incentive Payment System (MIPS)
- Final score
- 82.73 of 100
- Quality
- 71.75
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 70.68
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R42177 | ND | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| PSJ Acquisition LLC | Current | Accepting new patients | |
| Riverview Healthcare Association | Current | Accepting new patients | |
| PSJ Acquisition LLC | Current | Accepting new patients | |
| Innovis Health LLC | Current | Accepting new patients | |
| Innovis Health LLC | Current | Accepting new patients | |
| Innovis Health, LLC | Current | Accepting new patients |
Locations
323 S Minnesota St
Crookston, MN 56716
Phone (218) 281-9200
400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364
3000 32nd Ave S
Fargo, ND 58103
Phone (701) 364-3000
510 4th St S
Fargo, ND 58103
Phone (701) 476-7200
Organizations & group practices 6
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.
-
- Multi-Specialty Clinic/Center
- Fargo, ND
- NPI 1144776576
-
- Family Medicine Physician
- Fargo, ND
- NPI 1437495264
-
- Psychologist
- Fargo, ND
- NPI 1720454267
-
- Multi-Specialty Clinic/Center
- East Grand Forks, MN
- NPI 1811918436
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Rural Acute Care Hospital
- Detroit Lakes, MN
- NPI 1679561088
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1573084800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1747267200000",
"number": "1669017265",
"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": "218-786-8364"
}
],
"practiceLocations": [
{
"address_1": "2400 32nd Ave S",
"address_purpose": "LOCATION",
"city": "Fargo",
"state": "ND",
"postal_code": "581035800",
"country_code": "US",
"telephone_number": "701-234-2000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WAHL",
"first_name": "HALEY",
"middle_name": "FAYE",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-11-07",
"last_updated": "2025-05-15",
"certification_date": "2025-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "ND",
"license": "R42177",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "ND",
"license": "R42177",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fargo, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.