Individual provider Active NPI

Jacquelyn J Meyer-Spitz, FNP

  • Nurse Practitioner
  • Fargo, ND
National Provider Identifier
1861494882
Registry record updated Dec 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
203776 Issued in ND
Practice address
3800 56TH Ave S
Fargo, ND 58104-6706
Phone
(800) 237-4629
NPI assigned
Aug 10, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP1654 AZ
Nurse Practitioner 363L00000X 203776 ND Primary
Nurse Practitioner 363L00000X 13625 MN

Addresses

Primary practice location

3800 56TH Ave S
Fargo, ND 58104-6706

Mailing address

3800 56TH Ave S
Fargo, ND 58104-6706
Phone (800) 237-4629

Other identifiers 2

IdentifierTypeStateIssuer
034961MedicaidAZ
CG7880OtherAZMEDICARE RAILROAD

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110628000589 MN Practitioner - Nurse Practitioner 9335235977 Reassigns benefits to 1 organization
I20251230002838 ND Practitioner - Nurse Practitioner 9335235977 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3800 56TH Ave S
Fargo, ND 58104-6706

PO Box
Suite 1060
Uniontown, OH 44685

Merit-based Incentive Payment System (MIPS)

Final score
84.06 of 100Reported as group
Quality
68.27
Promoting interoperability
100
Improvement activities
40
Cost
78.59

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
13625MNMDNurse Practitioner
203776NDMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hospice of the Red River Valley CurrentSince Dec 2, 2025 Accepting new patients
Lakeside Orthopedic Institute LLC CurrentSince May 1, 2023 Accepting new patients
Lakeside Orthopedic Institute LLC Current Accepting new patients
Red River Valley Health Care PC CurrentSince Dec 21, 2025 Accepting new patients
Lakeside Orthopedic Institute, LLC CurrentSince May 1, 2023 Accepting new patients
Innovative Primary Care of Lake Havasu LLC Current Accepting new patients
UC Physicians of Parker Az Nurse Practitioner Past Accepting new patients
Arizona Heart Specialists PLLC Past Accepting new patients
Lakeside Orthopedic Institute LLC Past Accepting new patients
Lakeside Orthopedic Institute LLC Past Accepting new patients

Locations

2440 Adobe Rd
Ste 101
Bullhead City, AZ 86442
Phone (928) 763-3181

3003 Highway 95
Ste 63
Bullhead City, AZ 86442
Phone (928) 763-7555

1944 Mesquite Ave
Lk Havasu Cty, AZ 86403
Phone (928) 505-9729

1720 Mesquite Ave
Ste 100
Lk Havasu Cty, AZ 86403
Phone (928) 855-1550

25 Riviera Blvd
Lk Havasu Cty, AZ 86403
Phone (928) 505-7246

1945 Mesquite Ave
Ste B
Lk Havasu Cty, AZ 86403
Phone (928) 733-6287

1713 S Kofa Ave
Ste A
Parker, AZ 85344
Phone (928) 669-7380

1415 Madison Ave
Detroit Lakes, MN 56501
Phone (218) 844-7119

208 Oppegard Ave NW
Twin Valley, MN 56584
Phone (218) 584-5181

3800 56th Ave S
Fargo, ND 58104
Phone (701) 356-1500

1701 38th St SW
Ste 101
Fargo, ND 58103
Phone (701) 356-1500

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765843200000",
    "number": "1861494882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 56TH AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581046706",
            "telephone_number": "800-237-4629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 56TH AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581046706",
            "telephone_number": "800-237-4629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEYER-SPITZ",
        "first_name": "JACQUELYN",
        "middle_name": "J",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-10",
        "last_updated": "2025-12-16",
        "certification_date": "2025-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "AP1654",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ND",
            "license": "203776",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "13625",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "034961",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CG7880",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.