Kiesha M. Onyeneho, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

69236 Issued in MN

Practice address

905 Main St
Lisbon, ND 58054-4334

Phone

(701) 683-6400

NPI assigned

Apr 9, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Kiesha Bullock Former name

Medicare fee-for-service enrollment

Enrolled in MN, ND2 enrollments

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 2

Specialty

Family Practice

Education

University of North Dakota School of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lisbon Area Health ServicesGroup PAC ID 4486562873, shared by 3 NPIs, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lisbon Area Health Services Hospital, Lisbon, ND, CCN 351311

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kieshaonyeneho@normd.allscriptsdirect.net

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.

• Lisbon Area Health Services

  • Critical Access Hospital
  • Lisbon, ND
  • NPI 1609872431

  ND

  Medicare reassignment NPD
• Lisbon Area Health Services

  • Clinic/Center
  • Lisbon, ND
  • NPI 1811168958

  ND

  Medicare reassignment NPD
• Innovis Health LLC

  • Family Medicine Physician
  • Moorhead, MN
  • NPI 1659617504

  Family Medicine, MN

  Medicare reassignment NPD
• Innovis Health LLC

  • Multi-Specialty Clinic/Center
  • Fargo, ND
  • NPI 1144776576

  Family Medicine

  NPD
• Innovis Health, LLC

  • General Acute Care Hospital
  • Fargo, ND
  • NPI 1215125463
  NPD
• Lisbon Area Health Services

  • Clinic/Center
  • Lisbon, ND
  • NPI 1184051971
  NPD
• Lisbon Area Health Services

  • Medicare Defined Swing Bed Hospital Unit
  • Lisbon, ND
  • NPI 1033292875
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Lisbon Area Health Services

  • Critical Access Hospital
  • Lisbon, ND
  • NPI 1609872431

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1523232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1669979449",
    "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",
            "telephone_number": "701-736-4180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 MAIN ST",
            "city": "LISBON",
            "state": "ND",
            "postal_code": "580544334",
            "telephone_number": "701-683-6400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "801 Belsly Blvd",
            "address_purpose": "LOCATION",
            "city": "Moorhead",
            "state": "MN",
            "postal_code": "565605055",
            "country_code": "US",
            "telephone_number": "218-364-6800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ONYENEHO",
        "first_name": "KIESHA",
        "middle_name": "M.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-09",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "69236",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIESHA",
            "last_name": "BULLOCK",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Brianna Nielsen, PT
• Rebecca Maire Nord
• North Dakota Veterans Home
• Nudak Ventures North Dakota LLC
• Chad Allan Olson, DC
• Cynthia Owre
• Parkside Home
• Ransom County Social Services
• Tricia Ann Roesler, LRD, CDE
• Jodi Kae Sandness-Rieger, DC

• Family Medicine Physician in Lisbon, ND
• Providers in Lisbon, ND by specialty
• Family Medicine Physician in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2024; 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.

Verify at the official NPI Registry.