Individual provider Active NPI

Leah Kathryn Swenson, FNP

  • Nurse Practitioner
  • Valley City, ND
National Provider Identifier
1891942405
Registry record updated Dec 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R23542 Issued in ND
Practice address
132 4TH Ave NE
Valley City, ND 58072-3056
Phone
(701) 845-8060
Fax
(701) 845-8067
NPI assigned
Aug 26, 2008
Last updated
Dec 26, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2015

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 R23542 ND Primary

Addresses

Primary practice location

132 4TH Ave NE
Valley City, ND 58072-3056

Mailing address

PO Box 6001
Fargo, ND 58108-6001
Phone (701) 845-8060

Other identifiers 1

IdentifierTypeStateIssuer
1458623MedicaidND

Other names 1

  • Leah Kathryn Myogeto Former name

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
I20090317000331 ND Practitioner - Nurse Practitioner 8820155948 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Innovis Health LLCGroup PAC ID 9931298155, 561 clinicians

Practice addresses (Care Compare)

132 4TH Ave NE
Valley City, ND 58072-3056
Phone (701) 845-8060

3000 32ND Ave S
Fargo, ND 58103-6132
Phone (701) 364-8000

819 Main St
Lisbon, ND 58054-4244
Phone (701) 683-4134

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R23542NDMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Innovis Health LLC CurrentSince Mar 9, 2015 Accepting new patients
Innovis Health, LLC CurrentSince Mar 9, 2015 Accepting new patients

Locations

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

3000 32nd Ave S
Fargo, ND 58103
Phone (701) 364-3000

132 4th Ave NE
Valley City, ND 58072
Phone (701) 845-8060

Organizations & group practices 2

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.

Hospital & facility affiliations 3

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": "1219708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451088000000",
    "number": "1891942405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6001",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581086001",
            "telephone_number": "701-845-8060",
            "fax_number": "701-845-8067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 4TH AVE NE",
            "city": "VALLEY CITY",
            "state": "ND",
            "postal_code": "580723056",
            "telephone_number": "701-845-8060",
            "fax_number": "701-845-8067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWENSON",
        "first_name": "LEAH",
        "middle_name": "KATHRYN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-26",
        "last_updated": "2015-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ND",
            "license": "R23542",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1458623",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LEAH",
            "last_name": "MYOGETO",
            "middle_name": "KATHRYN",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Valley City, ND

Sources for this page

Verify at the official NPI Registry.