Individual provider Active NPI

Lea M Floberg, FNP C

  • Nurse Practitioner
  • Dickinson, ND
National Provider Identifier
1881673119
Registry record updated Feb 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R26888 Issued in ND
Practice address
2500 Fairway St
Dickinson, ND 58601-2639
Phone
(701) 456-4200
NPI assigned
Jan 13, 2006
Last updated
Feb 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R26888 ND Primary

Addresses

Primary practice location

2500 Fairway St
Dickinson, ND 58601-2639

Mailing address

2972 108S Ave SW
Dickinson, ND 58601-8004
Phone (701) 456-9721

Other identifiers 1

IdentifierTypeStateIssuer
1452997MedicaidND

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
I20040514000928 ND Practitioner - Nurse Practitioner 0648260380 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Richardton Taylor Rural Ambulance District Current Accepting new patients
St. Joseph's Hospital and Health Center CurrentSince Feb 22, 2016 Accepting new patients
St Joseph's Hospital and Health Center Current Accepting new patients
St. Joseph's Hospital and Health Center CurrentSince Feb 22, 2016 Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients

Locations

7360 Solutions Ctr
Chicago, IL 60677
Phone (701) 237-8033

2500 Fairway St
Dickinson, ND 58601
Phone (701) 456-4000

4784 Amber Valley Pkwy S
Fargo, ND 58104

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1137110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1881673119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2972 108S AVE SW",
            "city": "DICKINSON",
            "state": "ND",
            "postal_code": "586018004",
            "telephone_number": "701-456-9721",
            "fax_number": "419-421-8435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 FAIRWAY ST",
            "city": "DICKINSON",
            "state": "ND",
            "postal_code": "586012639",
            "telephone_number": "701-456-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLOBERG",
        "first_name": "LEA",
        "middle_name": "M",
        "credential": "FNP C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-13",
        "last_updated": "2024-02-06",
        "certification_date": "2024-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ND",
            "license": "R26888",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1452997",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dickinson, ND

Sources for this page

Verify at the official NPI Registry.