Individual provider Active NPI

Fallon Hoverson, MD

  • Family Medicine Physician
  • Grand Forks, ND
National Provider Identifier
1871889642
Registry record updated Jun 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
RL11978 Issued in ND
Practice address
725 Hamline St
Grand Forks, ND 58203-2819
Phone
(701) 780-6000
Fax
(701) 780-4391
NPI assigned
Jun 21, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X RL11978 ND Primary

Addresses

Primary practice location

725 Hamline St
Grand Forks, ND 58203-2819

Mailing address

2401 Demers Ave
Grand Forks, ND 58201-4183
Phone (701) 780-4085

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address fhoverson29092@direct.directaltru.org Direct

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141023002700 ND Practitioner - Family Practice 4183845787 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of North Dakota School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Altru Health SystemGroup PAC ID 1355251604, 675 clinicians

Practice addresses (Care Compare)

1200 S Columbia Rd
Grand Forks, ND 58201-4036
Phone (701) 780-5000

1380 S Columbia Rd
Grand Forks, ND 58201-4059
Phone (701) 795-2000

725 Hamline St
Grand Forks, ND 58203-2819
Phone (701) 780-6800

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
RL11978NDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Altru Health System CurrentSince Oct 1, 2014 Accepting new patients
Altru Health System Family Medicine Current Accepting new patients
Altru Health System CurrentSince Oct 1, 2014 Accepting new patients

Locations

1380 S Columbia Rd
Grand Forks, ND 58201
Phone (701) 795-2000

1200 S Columbia Rd
Grand Forks, ND 58201
Phone (701) 780-5243

725 Hamline St
Grand Forks, ND 58203
Phone (701) 777-6800

2401 Demers Ave
Grand Forks, ND 58201
Phone (701) 780-1891

4440 S Washington St
Grand Forks, ND 58201
Phone (701) 732-7000

Organizations & group practices 3

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 2

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": "1308614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591574400000",
    "number": "1871889642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 DEMERS AVE",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582014183",
            "telephone_number": "701-780-4085",
            "fax_number": "701-780-4477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 HAMLINE ST",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582032819",
            "telephone_number": "701-780-6000",
            "fax_number": "701-780-4391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOVERSON",
        "first_name": "FALLON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-21",
        "last_updated": "2020-06-08",
        "certification_date": "2020-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ND",
            "license": "RL11978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "fhoverson29092@direct.directaltru.org",
            "affiliation": "N",
            "endpointDescription": "Direct mail",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "725 Hamline St",
            "city": "Grand Forks",
            "state": "ND",
            "country_code": "US",
            "postal_code": "582032819",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Grand Forks, ND

Sources for this page

Verify at the official NPI Registry.