Organization Active NPI

Willow Health, PLLC

  • Family Medicine Physician
  • Fargo, ND
National Provider Identifier
1780426643
Registry record updated Jun 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
WILLOW HEALTH, PLLC
Practice address
3101 Broadway N Ste B
Fargo, ND 58102-1485
Phone
(701) 658-5577
Fax
(701) 888-5595
NPI assigned
Jun 11, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2026

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

Authorized official

Name
Dr. Jessie Samantha Lindemann, MDNPI 1427492677
Title
President
Phone
(608) 445-2692

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

3101 Broadway N Ste B
Fargo, ND 58102-1485

Mailing address

3101 Broadway N Ste B
Fargo, ND 58102-1485
Phone (701) 658-5577

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241118002355 ND Part B Supplier - Clinic/Group Practice 0547794224 Receives reassigned benefits from 1 practitioner
Practice locations: Fargo, ND

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
35D2332188Willow Health, PLLC3101 Broadway N Suite B, Fargo, ND 58102Certificate of waiverOct 14, 2027

National Provider Directory

National Provider Directory

Locations

3101 Broadway N
Ste B
Fargo, ND 58102
Phone (701) 658-5577

4133 30th Ave S
Fargo, ND 58104

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1718064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780444800000",
    "number": "1780426643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 BROADWAY N STE B",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581021485",
            "telephone_number": "701-658-5577",
            "fax_number": "701-888-5595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 BROADWAY N STE B",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581021485",
            "telephone_number": "701-658-5577",
            "fax_number": "701-888-5595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOW HEALTH, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-11",
        "last_updated": "2026-06-03",
        "certification_date": "2026-06-03",
        "status": "A",
        "authorized_official_last_name": "LINDEMANN",
        "authorized_official_first_name": "JESSIE",
        "authorized_official_middle_name": "SAMANTHA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "608-445-2692",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "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 Jun 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.