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ESSENTIA HEALTH LISBON CLINIC
NPI 1043490790
Family Medicine in Lisbon, ND

Active since November 10, 2007CLIA 35D0408217 · Waiver
819 MAIN ST, LISBON, ND 58054(701) 683-4134(701) 683-4094 Get Directions Write a Review

NPPES record last updated: March 1, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Essentia Health Lisbon Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ESSENTIA HEALTH LISBON CLINIC (NPI 1043490790) is a healthcare organization registered as a family medicine in Lisbon, North Dakota and active in the NPI registry since November 2007. The organization holds a CLIA Waiver certificate valid through March 9, 2028 and lists Alan Hurley, Coo, as its authorized official.

NPPES Registry Identity

NPI1043490790
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameINNOVIS HEALTH, LLC.
Location Address819 MAIN STLisbon, ND 58054-4244
Mailing AddressPo Box 1450 Nw 7813Minneapolis, MN 55485-7813 · (701) 253-5300 · Fax (701) 253-5402
Phone(701) 683-4134
Fax(701) 683-4094
Organization SubpartYesParent: Essentia Health
Authorized OfficialAlan HurleyCoo · (701) 364-7667
Enumeration DateNovember 10, 2007
Last NPPES UpdateMarch 1, 2024
NPPES CertifiedMarch 1, 2024
✔ NPI 1043490790 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
819 MAIN ST, Lisbon, ND 58054
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Other Names 1

Doing Business AsEssentia Health Lisbon Clinic

Other Identifiers 1

Medicaid716483300MN

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of North Dakota, Medica, Sanford Health Plan.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 35D0408217

Essentia Health Lisbon · Lisbon, ND
Active · expires Mar 9, 2028
CLIA Number35D0408217
Laboratory TypePhysician Office
Certificate Effective DateMarch 10, 2026
Certificate Expiration DateMarch 9, 2028
Laboratory DirectorMelanie M. Gullickson
Laboratory Phone(701) 683-4134
Laboratory LocationEssentia Health Lisbon819 Main St, Lisbon, ND 58054
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DAKOTA CLINIC, LTD.
Family Medicine
819 MAIN ST
LISBON, ND 58054
Ransom County (701) 683-4134
HILLARY M NEWBORG APRN,CNP
Nurse Practitioner (Family)
819 MAIN ST
LISBON, ND 58054
Ransom County (701) 693-4134
KATIE L TANNER PA
Physician Assistant
819 MAIN ST
LISBON, ND 58054
Ransom County (701) 683-4134
BRUCE D LARSON PAC
Physician Assistant
819 MAIN ST
LISBON, ND 58054
Ransom County (701) 683-4134
CARLY JO SCHULTZ PA-C
Physician Assistant
819 MAIN ST
LISBON, ND 58054
Ransom County (701) 683-4134
ELISHA D ANDERSON NP-C
Nurse Practitioner
819 MAIN ST
LISBON, ND 58054
Ransom County (701) 683-4134

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Innovis Health, LLC.'s NPI number?

The NPI number for Innovis Health, LLC. is 1043490790. It was assigned to this organization in the NPPES registry on November 10, 2007. The provider is doing business as Essentia Health Lisbon Clinic.

Where is Innovis Health, LLC. located?

Innovis Health, LLC. is located at 819 Main St, Lisbon, ND 58054. The listed phone number is (701) 683-4134.

What is Innovis Health, LLC.'s specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Innovis Health, LLC. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 35D0408217) is associated with this NPI, valid through March 9, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Innovis Health, LLC. accept?

Health plans from Blue Cross Blue Shield of North Dakota, Medica and Sanford Health Plan list Innovis Health, LLC. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Innovis Health, LLC. was last updated on March 1, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.