Headwaters Health PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

HEADWATERS HEALTH PC

Practice address

111 2ND St NE
Fosston, MN 56542-1301

Phone

(218) 435-1111

NPI assigned

Aug 26, 2025

Last updated

Nov 11, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Cheryl White, MDNPI 1457791725

Title

MD

Phone

(218) 435-1111

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Cheryl White, MD

  • Family Medicine Physician
  • Fosston, MN
  • NPI 1457791725
  Medicare reassignment Care Compare group NPD Authorized official
• Vickie M Anderson, PT

  • Physical Therapist
  • Fosston, MN
  • NPI 1164984647
  Medicare reassignment Care Compare group NPD
• Rhonda Lee Breitbach, DPT

  • Physical Therapist
  • Crookston, MN
  • NPI 1770729659
  Medicare reassignment Care Compare group NPD
• Maija L Duppong

  • Family Nurse Practitioner
  • Fosston, MN
  • NPI 1053555797
  Medicare reassignment Care Compare group NPD
• Bryan Mikael Johnson, PA-C

  • Physician Assistant
  • Fosston, MN
  • NPI 1477106714
  Medicare reassignment Care Compare group NPD
• Nicole Marie Kiesow, PA-C

  • Physician Assistant
  • Fosston, MN
  • NPI 1356502769
  Medicare reassignment Care Compare group NPD
• Carlie J Pletschett, APRN, CNP

  • Family Nurse Practitioner
  • Fosston, MN
  • NPI 1790581791
  Medicare reassignment Care Compare group NPD
• Darren D Swanson, MD

  • Family Medicine Physician
  • Fosston, MN
  • NPI 1912942566
  Medicare reassignment Care Compare group NPD
• Sheila K Teiken, APRN,CNP

  • Family Nurse Practitioner
  • Fosston, MN
  • NPI 1124730726
  Medicare reassignment Care Compare group NPD
• Jacob Arthur Vossler, DPT

  • Physical Therapist
  • Fosston, MN
  • NPI 1538588579
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1756166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762819200000",
    "number": "1821976903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 2ND ST NE",
            "city": "FOSSTON",
            "state": "MN",
            "postal_code": "565421301",
            "telephone_number": "218-435-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 2ND ST NE",
            "city": "FOSSTON",
            "state": "MN",
            "postal_code": "565421301",
            "telephone_number": "218-435-1111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "104 Kaiser Ave N",
            "address_purpose": "LOCATION",
            "city": "Fosston",
            "state": "MN",
            "postal_code": "565421225",
            "country_code": "US",
            "telephone_number": "218-435-1111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HEADWATERS HEALTH PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-26",
        "last_updated": "2025-11-11",
        "certification_date": "2025-11-11",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "218-435-1111",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fosston Pharmacy & Gifts Inc (Nords Pharmacy and Gifts)
• Jennifer Francis, ATC
• Karissa Goetsch, DDS
• Camille J Hagen, RD,LD
• David E. Halvorson
• Health Services Network, Inc (Cornerstone Residence)
• Leah Ann Hemmingsen
• Jordyn M Himley
• Kari Hitchen
• Independent School District #601

• Family Medicine Physician in Fosston, MN
• Providers in Fosston, MN by specialty
• Family Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2025; 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.