1215511167 NPI number — CHI HEALTH CONNECT AT HOME-FARGO

Table of content: DR. ANDREW VINCENT ATTON MD (NPI 1235124538)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215511167 NPI number — CHI HEALTH CONNECT AT HOME-FARGO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHI HEALTH CONNECT AT HOME-FARGO
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1215511167
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/22/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4265 45TH ST S STE 200
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FARGO
Provider Business Mailing Address State Name:
ND
Provider Business Mailing Address Postal Code:
58104-4309
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
888-538-0069
Provider Business Mailing Address Fax Number:
701-237-8199

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1110 HIGHWAY 75 N STE A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BRECKENRIDGE
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
56520-1108
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
218-643-2275
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/07/2021

Additional Information

Authorized Official

Authorized Official Last Name:
PEYERL
Authorized Official First Name:
NICOLE
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR OPERATIONS/AUTH OFFICIAL
Authorized Official Telephone Number:
701-238-3206

Provider Taxonomy Codes

  • Taxonomy code: 261QH0100X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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