Individual provider Active NPI

Anne M Earsley, PA-C

  • Physician Assistant
  • Bismarck, ND
National Provider Identifier
1679518484
Registry record updated May 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PAC0335 Issued in ND
Practice address
1000 E Rosser Ave
Bismarck, ND 58501-4414
Phone
(701) 715-4500
NPI assigned
Jun 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PAC0335 ND Primary

Addresses

Primary practice location

1000 E Rosser Ave
Bismarck, ND 58501-4414

Mailing address

401 N 9TH St
Bismarck, ND 58501-4507
Phone (701) 712-4518

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051020000577 ND Practitioner - Physician Assistant 3072539824 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
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)

1000 E Rosser Ave
Bismarck, ND 58501-4414
Phone (701) 712-4500

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

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PAC0335NDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Innovis Health LLC CurrentSince Oct 1, 2022 Accepting new patients
Innovis Health, LLC CurrentSince Oct 1, 2022 Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients
Innovis Health, LLC Past Accepting new patients

Locations

1000 E Rosser Ave
Bismarck, ND 58501
Phone (701) 530-6000

401 N 9th St
Bismarck, ND 58501
Phone (701) 530-6000

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

Organizations & group practices 5

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 1

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": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684195200000",
    "number": "1679518484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 N 9TH ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585014507",
            "telephone_number": "701-712-4518",
            "fax_number": "701-712-4191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E ROSSER AVE",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585014414",
            "telephone_number": "701-715-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EARSLEY",
        "first_name": "ANNE",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-17",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ND",
            "license": "PAC0335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bismarck, ND

Sources for this page

Verify at the official NPI Registry.