| CHI Lisbon Health | |
|
905 Main Street Lisbon ND 58054 | |
| (701) 683-6400 | |
| (701) 683-6444 |
| Full Name | CHI Lisbon Health |
|---|---|
| Speciality | Clinic/Center |
| Location | 905 Main Street, Lisbon, North Dakota |
| Authorized Official Name and Position | Peggy Larson (ADMINISTRATOR) |
| Authorized Official Contact | 7016836419 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| CHI Lisbon Health 905 Main Street Lisbon ND 58054 Ph: (701) 683-6400 | CHI Lisbon Health 905 Main Street Lisbon ND 58054 Ph: (701) 683-6400 |
| NPI Number | 1811168958 |
|---|---|
| Provider Enumeration Date | 03/17/2008 |
| Last Update Date | 04/29/2019 |
| Medicare PECOS PAC ID | 4486562873 |
|---|---|
| Medicare Enrollment ID | O20041008000975 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811168958 | NPI | - | NPPES |
| 1463286 | Medicaid | ND |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (NU) | Primary |
| 207P00000X | Emergency Medicine | 5031B (North Dakota) | Secondary |
| Provider Name | Jennifer M Reiman |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1821106485 PECOS PAC ID: 4789671108 Enrollment ID: I20040902000846 |
| Provider Name | Stacey M Walton |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1801868062 PECOS PAC ID: 6406874668 Enrollment ID: I20051105000371 |
| Provider Name | Kevin S Jacobson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528093077 PECOS PAC ID: 7315043650 Enrollment ID: I20070503000397 |
| Provider Name | Jacqueline D Nelson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1750586772 PECOS PAC ID: 2567568009 Enrollment ID: I20070731000372 |
| Provider Name | David Lopez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275629719 PECOS PAC ID: 0648241232 Enrollment ID: I20071009000104 |
| Provider Name | Danny Wolfgram |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861473753 PECOS PAC ID: 1951334903 Enrollment ID: I20080414000015 |
| Provider Name | Thomas B Matheson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1558365106 PECOS PAC ID: 8921035213 Enrollment ID: I20080527000709 |
| Provider Name | Brenda M Rick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720273436 PECOS PAC ID: 9830254184 Enrollment ID: I20090219000525 |
| Provider Name | Shawna L Dobrzelecki |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205023926 PECOS PAC ID: 1355430430 Enrollment ID: I20090904000513 |
| Provider Name | Mark W Klabo |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1275793978 PECOS PAC ID: 1759419211 Enrollment ID: I20100505000095 |
| Provider Name | Brent M Buchholz |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1619288305 PECOS PAC ID: 9032243456 Enrollment ID: I20100819001059 |
| Provider Name | Barbara Sheets Olson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477538775 PECOS PAC ID: 6608832365 Enrollment ID: I20100910000237 |
| Provider Name | Tara M Nardacci |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972734499 PECOS PAC ID: 7214077148 Enrollment ID: I20101020000472 |
| Provider Name | Clark Kruta |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1205862273 PECOS PAC ID: 4284723461 Enrollment ID: I20110225000143 |
| Provider Name | Katie a Obrien Paradis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164689931 PECOS PAC ID: 0840337630 Enrollment ID: I20111109000219 |
| Provider Name | Amy Bakke |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1750340360 PECOS PAC ID: 6709891534 Enrollment ID: I20130529000932 |
| Provider Name | James M Gabriel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235577685 PECOS PAC ID: 5395988968 Enrollment ID: I20130829000413 |
| Provider Name | Lori Ann Hill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659462901 PECOS PAC ID: 9638309701 Enrollment ID: I20140311001879 |
| Provider Name | Jeffrey Scott Adams |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1689791709 PECOS PAC ID: 3173695400 Enrollment ID: I20140402000732 |
| Provider Name | Leighanne a Houserman |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1063487684 PECOS PAC ID: 1557523792 Enrollment ID: I20140924001800 |
| Provider Name | Rylan Brantl |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1013178326 PECOS PAC ID: 0648595983 Enrollment ID: I20150209002090 |
| Provider Name | Chassidy Sharp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720475767 PECOS PAC ID: 8022322288 Enrollment ID: I20150731015351 |
| Provider Name | Nathan P Kersey |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1922216142 PECOS PAC ID: 6002902285 Enrollment ID: I20151015000640 |
| Provider Name | Jessica R Wichmann |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1326373317 PECOS PAC ID: 5890837306 Enrollment ID: I20160311000954 |
| Provider Name | Noelle K Riehl |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346600251 PECOS PAC ID: 5092012021 Enrollment ID: I20160318000611 |
| Provider Name | Nathan G Tiedeman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285083436 PECOS PAC ID: 1153613906 Enrollment ID: I20160801000663 |
| Provider Name | Erika Beckett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861649071 PECOS PAC ID: 9638230279 Enrollment ID: I20170301000487 |
| Provider Name | Rachel Faleide |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518406826 PECOS PAC ID: 0244515690 Enrollment ID: I20170327000930 |
| Provider Name | Christina M Arauz |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1114331055 PECOS PAC ID: 0143592733 Enrollment ID: I20170816003118 |
| Provider Name | James Richard Pantel |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1215474762 PECOS PAC ID: 5991748840 Enrollment ID: I20170925000831 |
| Provider Name | Jodi Lynn Sherve |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255825253 PECOS PAC ID: 1557613577 Enrollment ID: I20181003000905 |
| Provider Name | Brittany Long |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831678036 PECOS PAC ID: 4880952589 Enrollment ID: I20181031003321 |
| Provider Name | Jessica Krauth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851774905 PECOS PAC ID: 6901112069 Enrollment ID: I20181106002559 |
| Provider Name | Brennen D Smith |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1376753277 PECOS PAC ID: 0749467280 Enrollment ID: I20190305001489 |
| Provider Name | Rose M Hoiten |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962496752 PECOS PAC ID: 3274568662 Enrollment ID: I20190716003337 |
| Provider Name | Syed Haris Ali |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1033598214 PECOS PAC ID: 7416283932 Enrollment ID: I20190722002444 |
| Provider Name | Larry Wayne Hoff |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1740455302 PECOS PAC ID: 1456421270 Enrollment ID: I20200416003612 |
| Provider Name | Michael L Hammer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730813130 PECOS PAC ID: 9032593140 Enrollment ID: I20220908000934 |
| Provider Name | Sarah Ellen Hansen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619697521 PECOS PAC ID: 6103161948 Enrollment ID: I20221103003155 |
| Provider Name | James Awuah |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1609347798 PECOS PAC ID: 0840531331 Enrollment ID: I20221109000517 |
| Provider Name | Alex Lunneborg |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1962072645 PECOS PAC ID: 9931505930 Enrollment ID: I20221124000153 |
| Provider Name | Joshua Hughes |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1487322764 PECOS PAC ID: 4587054606 Enrollment ID: I20221125000079 |
| Provider Name | Krista Thielges Kjelland |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1164161386 PECOS PAC ID: 6204205198 Enrollment ID: I20221215002907 |
| Provider Name | Vanessa Chen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972817328 PECOS PAC ID: 6709028350 Enrollment ID: I20230725004089 |
| Provider Name | Barkot Gebremichael |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538595863 PECOS PAC ID: 9739471509 Enrollment ID: I20230728001845 |
| Provider Name | Ricardy Rimpel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871854125 PECOS PAC ID: 2466691167 Enrollment ID: I20230802002081 |
| Provider Name | Temple Anzalone |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1265546642 PECOS PAC ID: 2769457779 Enrollment ID: I20230808002634 |
| Provider Name | Maryam Gbadamosi-akindele |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619231131 PECOS PAC ID: 8921312455 Enrollment ID: I20230905000910 |
| Provider Name | Shahabuddin Ahmed |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1174899546 PECOS PAC ID: 7214255819 Enrollment ID: I20230919000952 |
| Provider Name | Darcie Tveidt |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1972841799 PECOS PAC ID: 1850546102 Enrollment ID: I20230919002267 |
| Provider Name | Adam Macdissi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1720399116 PECOS PAC ID: 9739321365 Enrollment ID: I20231023003582 |
| Provider Name | Twethida Oung |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1790946481 PECOS PAC ID: 7810179256 Enrollment ID: I20231025001744 |
| Provider Name | Artem Ryazantsev |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1043653108 PECOS PAC ID: 9335431204 Enrollment ID: I20231025003350 |
| Provider Name | Angela Christine Widler |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1457776049 PECOS PAC ID: 1052536919 Enrollment ID: I20231130002879 |
| Provider Name | Kiesha Onyeneho |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669979449 PECOS PAC ID: 0941557516 Enrollment ID: I20231215002653 |
| Provider Name | Akwaugo Thelma Uzoegwu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033506332 PECOS PAC ID: 1254678071 Enrollment ID: I20240603003836 |
| Provider Name | Kelli Mcallister |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427054105 PECOS PAC ID: 7810951357 Enrollment ID: I20240718001947 |
| Provider Name | Leslie Ann Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962647149 PECOS PAC ID: 0143368498 Enrollment ID: I20240910003647 |
| Provider Name | Christopher H Horton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457801904 PECOS PAC ID: 1759662786 Enrollment ID: I20241107004038 |
| Provider Name | Mohammed Zalabani |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1427345966 PECOS PAC ID: 7618106659 Enrollment ID: I20241115001302 |
| Provider Name | Adriana Andrea Escandon Sandino |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1942327689 PECOS PAC ID: 5092996686 Enrollment ID: I20241226002577 |
| Provider Name | Courtney Whitney |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1861461329 PECOS PAC ID: 9739087826 Enrollment ID: I20250124003506 |
| Provider Name | Brianna Kay Eli |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003703885 PECOS PAC ID: 9739696741 Enrollment ID: I20250725000406 |
| Provider Name | Shagufta Hayat |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578979621 PECOS PAC ID: 1658598560 Enrollment ID: I20250829001592 |
| Provider Name | Makenzi Stevenson |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1770100901 PECOS PAC ID: 9133544604 Enrollment ID: I20250831000247 |
| Provider Name | Jackie Lindberg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629604087 PECOS PAC ID: 7315339488 Enrollment ID: I20251017001201 |
| Provider Name | Purav Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902338742 PECOS PAC ID: 7719224104 Enrollment ID: I20251022003570 |
| Provider Name | Abigail Ruby Andersen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639046311 PECOS PAC ID: 5991290934 Enrollment ID: I20251217004036 |
| Provider Name | Akua Fordjour |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285040626 PECOS PAC ID: 2961781109 Enrollment ID: I20260103510156 |
| Provider Name | Mckenzee Kemper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811527260 PECOS PAC ID: 8022446608 Enrollment ID: I20260106002975 |
Essentia Health Lisbon Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 819 Main St, Lisbon, ND 58054 Phone: 701-683-4134 Fax: 701-683-4094 |
Dakota Clinic, Ltd. - Lisbon Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 819 Main St, Lisbon, ND 58054 Phone: 701-683-4134 Fax: 701-683-4094 |
Southeast Medical Center PC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 102 10th Avenue West, Lisbon, ND 58054 Phone: 701-683-2214 Fax: 701-683-2130 |
CHI Lisbon Health Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 905 Main St, Lisbon, ND 58054 Phone: 701-683-6400 |
Family Medical Clinic PC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10 9th Ave E, Lisbon, ND 58054 Phone: 701-683-4711 Fax: 701-683-3205 |