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CANOPY MEDICAL CLINIC, PLLC
NPI 1386280261
Nurse Practitioner - Women's Health in Fargo, ND

Active since November 26, 2019CLIA 35D2176936 · Microscopy
1411 32ND ST S STE 1, FARGO, ND 58103(701) 306-0943 Get Directions Write a Review

NPPES record last updated: January 7, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 7, 2025, Jan 31, 2020, Dec 17, 2019 and 1 more (4 updates tracked since 2019).

About Canopy Medical Clinic, Pllc NPPES

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

CANOPY MEDICAL CLINIC, PLLC (NPI 1386280261) is a healthcare organization registered as a women's health in Fargo, North Dakota and active in the NPI registry since November 2019. The organization holds a CLIA Microscopy certificate valid through December 29, 2027 and lists Heidi Selzler-echola, Medical Director, as its authorized official.

NPPES Registry Identity

NPI1386280261
Entity TypeOrganization
Primary Taxonomy363LW0102X
Legal Business NameCANOPY MEDICAL CLINIC, PLLC
Location Address1411 32ND ST S STE 1Fargo, ND 58103-6304
Mailing Address1411 32nd St S Ste 1Fargo, ND 58103-6304 · (701) 264-5200
Phone(701) 306-0943
Organization SubpartNo
Authorized OfficialHeidi Selzler-echolaMedical Director · (701) 264-5200
Enumeration DateNovember 26, 2019
Last NPPES UpdateJanuary 7, 20254 updates tracked since enumeration
NPPES CertifiedJanuary 7, 2025
✔ NPI 1386280261 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Women's HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LW0102X
1411 32ND ST S STE 1, Fargo, ND 58103
Open in Google Maps ↗

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 for Provider-Performed Microscopy Procedures (PPMP) 35D2176936

Canopy Medical Clinic · Fargo, ND
Active · expires Dec 29, 2027
CLIA Number35D2176936
Laboratory TypePractitioner Other
Certificate Effective DateDecember 30, 2025
Certificate Expiration DateDecember 29, 2027
Laboratory DirectorHeidi L. Selzler-Echola
Laboratory Phone(701) 264-5200
Laboratory LocationCanopy Medical Clinic1411 32nd St S, Ste 1, Fargo, ND 58103
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 5

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

TAYLOR N ENSRUDE DDS
Dentist
1411 32ND ST S STE 1
FARGO, ND 58103
Cass County (701) 235-8978
MEGAN P EVJEN LBSW
Social Worker
1411 32ND ST S STE 1
FARGO, ND 58103
Cass County (701) 264-5200
STEPHAN ROBERT NOLL
Counselor (Mental Health)
1411 32ND ST S STE 1
FARGO, ND 58103
Cass County (701) 264-5200
MICHAELA KATHLEEN SWANSTON RN
Registered Nurse
1411 32ND ST S STE 1
FARGO, ND 58103
Cass County (701) 264-5200
CONCEPT DENTISTRY PC
Clinic/Center (Dental)
1411 32ND ST S STE 1
FARGO, ND 58103
Cass County (701) 235-8978

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 Canopy Medical Clinic, PLLC's NPI number?

The NPI number for Canopy Medical Clinic, PLLC is 1386280261. It was assigned to this organization in the NPPES registry on November 26, 2019.

Where is Canopy Medical Clinic, PLLC located?

Canopy Medical Clinic, PLLC is located at 1411 32nd St S Ste 1, Fargo, ND 58103. The listed phone number is (701) 306-0943.

What is Canopy Medical Clinic, PLLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Women's Health, with taxonomy code 363LW0102X.

Does Canopy Medical Clinic, PLLC hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 35D2176936) is associated with this NPI, valid through December 29, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Canopy Medical Clinic, PLLC accept?

Health plans from Blue Cross Blue Shield of North Dakota, Medica and Sanford Health Plan list Canopy Medical Clinic, PLLC 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 Canopy Medical Clinic, PLLC was last updated on January 7, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 months 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.