Prairie St John's - Medicare Mental Health Clinic in Fargo, ND

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Prairie St John's is a medicare enrolled mental health clinic (Psychiatric Hospital) in Fargo, North Dakota. The current practice location for Prairie St John's is 510 4th St S, Fargo, North Dakota. For appointments, you can reach them via phone at (701) 476-7200. The mailing address for Prairie St John's is 510 4th St S, Fargo, North Dakota and phone number is (701) 476-7200.

Prairie St John's is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1679709802. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (701) 476-7200.

Contact Information

Prairie St John's
510 4th St S
Fargo
ND 58103
(701) 476-7200
(701) 280-5789

Map and Direction


Mental Health Clinic Profile

Full NamePrairie St John's
SpecialityPsychiatric Hospital
Location510 4th St S, Fargo, North Dakota
Authorized Official Name and PositionSteve Filton (SRVP CFO)
Authorized Official Contact6107683300
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Prairie St John's
510 4th St S
Fargo
ND 58103

Ph: (701) 476-7200		Prairie St John's
510 4th St S
Fargo
ND 58103

Ph: (701) 476-7200

NPI Details:

NPI Number1679709802
Provider Enumeration Date06/02/2009
Last Update Date04/29/2024
Certification Date04/29/2024

Medicare PECOS Information:

Medicare PECOS PAC ID7012062235
Medicare Enrollment IDO20090918000240

Medical Identifiers

Medical identifiers for Prairie St John's such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1679709802NPI-NPPES
11051MedicaidND
99725100MedicaidMN

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
2084P0800XPsychiatry & Neurology - Psychiatry (* (Not Available))Secondary
283Q00000XPsychiatric Hospital (* (Not Available))Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Prairie St John's acts as a billing entity for following providers:
Provider NameTamara M Madler
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1053474411
PECOS PAC ID: 0648162024
Enrollment ID: I20040329001428
Provider NameFetih Akgul
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1093807182
PECOS PAC ID: 8224057724
Enrollment ID: I20051114001098
Provider NameCarole Y Halone
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1144323700
PECOS PAC ID: 7719089457
Enrollment ID: I20070226000787
Provider NameDavid J Mach
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1497945158
PECOS PAC ID: 8123114337
Enrollment ID: I20071019000115
Provider NameCharlotte M Andersen
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1023111606
PECOS PAC ID: 3779512678
Enrollment ID: I20071112000577
Provider NameGina Marie Cook
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1063696425
PECOS PAC ID: 9537218029
Enrollment ID: I20090512000224
Provider NameJenny K Frissell
Provider TypePractitioner - Clinical Psychologist
Provider IdentifiersNPI Number: 1467555078
PECOS PAC ID: 5698811925
Enrollment ID: I20090930000189
Provider NameBooker T Evans
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1093756736
PECOS PAC ID: 2769495050
Enrollment ID: I20091118000258
Provider NameCheryl Sartain
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1255648051
PECOS PAC ID: 2163619784
Enrollment ID: I20101208001249
Provider NameTim A Smith
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1881821619
PECOS PAC ID: 1254517113
Enrollment ID: I20130102000442
Provider NameDonald E Wiger
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1427285253
PECOS PAC ID: 1052565488
Enrollment ID: I20130211000574
Provider NameRachel Kvasager
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1134468192
PECOS PAC ID: 1456598499
Enrollment ID: I20130510000074
Provider NameJacqualine Gervais
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1336481803
PECOS PAC ID: 1658519632
Enrollment ID: I20130603000617
Provider NameLacey L Armstrong
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1942520325
PECOS PAC ID: 8628218658
Enrollment ID: I20130715000639
Provider NameSteven Meek
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1093005639
PECOS PAC ID: 6709013766
Enrollment ID: I20140708000857
Provider NameAnthony Vaca
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1700858248
PECOS PAC ID: 8123038023
Enrollment ID: I20140910000601
Provider NameNivedita S Nadkarni
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1346479185
PECOS PAC ID: 3173752912
Enrollment ID: I20140917003125
Provider NameNils-erik J Juanto Laver
Provider TypePractitioner - Clinical Psychologist
Provider IdentifiersNPI Number: 1306274600
PECOS PAC ID: 3476772708
Enrollment ID: I20140917003166
Provider NameMatthew A Mcdougall
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1730446204
PECOS PAC ID: 0840420675
Enrollment ID: I20141024000220
Provider NameDaniel A Danczyk
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1639303894
PECOS PAC ID: 8224210141
Enrollment ID: I20141119000313
Provider NameKathryn A Ney
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1154366144
PECOS PAC ID: 5799959532
Enrollment ID: I20150318002289
Provider NameKari Dubosque
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1235496191
PECOS PAC ID: 3476864166
Enrollment ID: I20150622002441
Provider NameAmy J Lavalla
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1215312236
PECOS PAC ID: 8224344890
Enrollment ID: I20150826002869
Provider NameSamardeep K Randhawa
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1265723134
PECOS PAC ID: 8224268057
Enrollment ID: I20150923001421
Provider NameAndrea Jean Nelsen
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1043442700
PECOS PAC ID: 0749423770
Enrollment ID: I20151029002799
Provider NameSusan Elaine Cassatt
Provider TypePractitioner - Clinical Psychologist
Provider IdentifiersNPI Number: 1831379767
PECOS PAC ID: 3476630252
Enrollment ID: I20151113002318
Provider NameEllen Elaine Tinsley
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1578833828
PECOS PAC ID: 3375706708
Enrollment ID: I20160127000303
Provider NameAmy Ulbricht
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1972862332
PECOS PAC ID: 7810286945
Enrollment ID: I20160512002325
Provider NameBrenda R. Collins
Provider TypePractitioner - Certified Clinical Nurse Specialist (cns)
Provider IdentifiersNPI Number: 1750730966
PECOS PAC ID: 1850684796
Enrollment ID: I20160729000642
Provider NameSoha Alammoury
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1750730834
PECOS PAC ID: 1557655859
Enrollment ID: I20160809003113
Provider NameAshley C Bishop
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1043763220
PECOS PAC ID: 4688960412
Enrollment ID: I20160902002002
Provider NameBalwinder Singh
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1588001671
PECOS PAC ID: 3971899659
Enrollment ID: I20160906002080
Provider NameEric John Monticello
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1558816306
PECOS PAC ID: 4688961980
Enrollment ID: I20160930000877
Provider NameCatherine R Mier
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1386087765
PECOS PAC ID: 6002195369
Enrollment ID: I20161109002890
Provider NameRyan Thomas Santin
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1649698523
PECOS PAC ID: 1658590088
Enrollment ID: I20161121000769
Provider NameEric C Tee
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1487075404
PECOS PAC ID: 8820380603
Enrollment ID: I20170406001231
Provider NameDerek M Smith
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1548607690
PECOS PAC ID: 6507172509
Enrollment ID: I20170419002703
Provider NameRoderick Williams
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1861917882
PECOS PAC ID: 0941575484
Enrollment ID: I20171113003238
Provider NameHeather Berney
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1568859809
PECOS PAC ID: 5294093472
Enrollment ID: I20171215002010
Provider NameTymberly S Seim
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1356736896
PECOS PAC ID: 7113206996
Enrollment ID: I20180309002315
Provider NameRyan Greene
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1104231505
PECOS PAC ID: 2668691700
Enrollment ID: I20180604002590
Provider NameLisa M Schock
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1548640949
PECOS PAC ID: 2668729328
Enrollment ID: I20180726000696
Provider NameTimothy S Fuchs
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1740410810
PECOS PAC ID: 5193981249
Enrollment ID: I20181119002559
Provider NameMaryn Young
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1073089439
PECOS PAC ID: 9436498789
Enrollment ID: I20190304001121
Provider NameShama Rathi
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1427493972
PECOS PAC ID: 9931441003
Enrollment ID: I20190422001913
Provider NameJohn A Person
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1770018228
PECOS PAC ID: 4880964634
Enrollment ID: I20190918000760
Provider NameAnna E Statz
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1235662982
PECOS PAC ID: 6608146451
Enrollment ID: I20191011001012
Provider NameCourtnee Renee Heyduk
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1568967446
PECOS PAC ID: 7315294964
Enrollment ID: I20200506003387
Provider NameEbony S Anderson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1336484542
PECOS PAC ID: 1557599354
Enrollment ID: I20200507000309
Provider NameHaley Faye Wahl
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1669017265
PECOS PAC ID: 7618398694
Enrollment ID: I20200529000236
Provider NameTracy K Fiser
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1154711943
PECOS PAC ID: 6406172014
Enrollment ID: I20200529001363
Provider NameAbby Fredrickson
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1376063370
PECOS PAC ID: 0547685125
Enrollment ID: I20200721002823
Provider NameRachel D Barnick
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1841817384
PECOS PAC ID: 7810315447
Enrollment ID: I20210707003956
Provider NameAmber M Olson
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1003377649
PECOS PAC ID: 3577899152
Enrollment ID: I20210917002464
Provider NameEmily Volesky
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1609546555
PECOS PAC ID: 2961890041
Enrollment ID: I20211021002130
Provider NameCarol A Whitman
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1346861473
PECOS PAC ID: 4981021805
Enrollment ID: I20211220002542
Provider NameSarah Abbott
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1396402475
PECOS PAC ID: 1557754439
Enrollment ID: I20220217001765
Provider NameKenneth Troxclair
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1902466436
PECOS PAC ID: 0840686960
Enrollment ID: I20220329002496
Provider NameJessie M Kier
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1538817259
PECOS PAC ID: 7810384823
Enrollment ID: I20220421001224
Provider NameMolly Wambach
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1558931097
PECOS PAC ID: 3375929904
Enrollment ID: I20221004003520
Provider NameKesley C Pike
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1891350351
PECOS PAC ID: 8628304284
Enrollment ID: I20221201000915
Provider NameChristopher J Clark
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1770084634
PECOS PAC ID: 8325462872
Enrollment ID: I20221201001543
Provider NameSarah A Terpstra
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1467164012
PECOS PAC ID: 4587038120
Enrollment ID: I20230321002398
Provider NameJared J Solomon
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1649605072
PECOS PAC ID: 5991162877
Enrollment ID: I20230608000615
Provider NameArpit Heer
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1861069833
PECOS PAC ID: 1052769163
Enrollment ID: I20231130001200
Provider NameLuke T. Mike
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1437726304
PECOS PAC ID: 6305294190
Enrollment ID: I20231205001800
Provider NameJoshua S Reider
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1053055111
PECOS PAC ID: 9032590906
Enrollment ID: I20240118003762
Provider NameJames P Mcgovern
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1790763928
PECOS PAC ID: 5698728939
Enrollment ID: I20240701004116
Provider NameMailyn M Mozingo
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1639950348
PECOS PAC ID: 6901342781
Enrollment ID: I20240729003479
Provider NameJeremy J Jones
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1225777311
PECOS PAC ID: 3072053883
Enrollment ID: I20240907000574
Provider NameHunter M Caskey
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1164874954
PECOS PAC ID: 5890027114
Enrollment ID: I20241009001921
Provider NameHallie M Anderson
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1629719794
PECOS PAC ID: 1153702006
Enrollment ID: I20241121002063

Reviews and Comments

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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.