| Anova Family Health Center Inc. | |
|
113 Main Street South Watford City ND 58854-2479 | |
| (701) 842-6400 | |
| (701) 842-6403 |
| Full Name | Anova Family Health Center Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 113 Main Street South, Watford City, North Dakota |
| Authorized Official Name and Position | Vonnie Jean Johnson (OWNER/OPERATOR) |
| Authorized Official Contact | 7018426400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Anova Family Health Center Inc. Po Box 2479 113 Main Street South Watford City ND 58854-2479 Ph: (701) 842-6400 | Anova Family Health Center Inc. 113 Main Street South Watford City ND 58854-2479 Ph: (701) 842-6400 |
| NPI Number | 1801145206 |
|---|---|
| Provider Enumeration Date | 08/31/2012 |
| Last Update Date | 12/14/2012 |
| Medicare PECOS PAC ID | 4789837659 |
|---|---|
| Medicare Enrollment ID | O20130102000163 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801145206 | NPI | - | NPPES |
| 1124279633 | Other | INDIVIDUAL NPI-VONNIE JOHNSON | |
| 1790030187 | Other | INDIVIDUAL NPI-ANITA PEDERSEN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Vonnie J Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124279633 PECOS PAC ID: 0648240648 Enrollment ID: I20040728000221 |
| Provider Name | Anita A Pedersen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790030187 PECOS PAC ID: 3577716448 Enrollment ID: I20130102000239 |
| Provider Name | Claudia G Low |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891073185 PECOS PAC ID: 4789840711 Enrollment ID: I20160920001925 |
| Provider Name | Misti Breitbach |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639627979 PECOS PAC ID: 6800921859 Enrollment ID: I20170308002401 |
| Provider Name | Lisa M Sanford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740896828 PECOS PAC ID: 7416377122 Enrollment ID: I20201019002887 |
| Provider Name | Christina Shockley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043824501 PECOS PAC ID: 8921033291 Enrollment ID: I20210315002348 |
| Provider Name | Laura Elizabeth Whiteley |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1942778055 PECOS PAC ID: 3577891043 Enrollment ID: I20220113001487 |
| Provider Name | Kordae J Hayden |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1356816128 PECOS PAC ID: 2466838594 Enrollment ID: I20220927003132 |
| Provider Name | Jade A Kelling |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366179509 PECOS PAC ID: 9234505090 Enrollment ID: I20221019000874 |
Mchs-clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 709 4th Ave Ne, Watford City, ND 58854 Phone: 701-842-3771 Fax: 701-842-4025 | |
Innovative Health Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 340 N Main St Ste 311, Watford City, ND 58854 Phone: 701-444-2888 Fax: 701-444-2813 | |
Mckenzie Health Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 709 4th Ave Ne, Watford City, ND 58854 Phone: 701-842-3771 Fax: 701-842-4025 |