HEADWATERS HEALTH PC
NPI 1821976903
Family Medicine in Fosston, MN
About Headwaters Health Pc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
HEADWATERS HEALTH PC (NPI 1821976903) is a healthcare organization registered as a family medicine in Fosston, Minnesota and active in the NPI registry since August 2025. The organization holds a CLIA Waiver certificate valid through October 13, 2027, maintains a secondary practice location in Fosston, and lists Cheryl White, Md, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Headwaters Health Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
8Medicare enrollment records show 8 clinicians reassign Medicare billing to Headwaters Health PC, which bills Medicare for the services they deliver. Of these, 5 practice at this address and 7 within 10 miles. They are listed nearest first.
Clinicians, nearest first (8)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 24D2332057
Headwaters Health · Fosston, MNFrequently 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 Headwaters Health PC's NPI number?
The NPI number for Headwaters Health PC is 1821976903. It was assigned to this organization in the NPPES registry on August 26, 2025.
Where is Headwaters Health PC located?
Headwaters Health PC is located at 111 2nd St NE, Fosston, MN 56542. The listed phone number is (218) 435-1111.
What is Headwaters Health PC's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Headwaters Health PC enrolled in Medicare?
Yes. Headwaters Health PC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Headwaters Health PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 8 clinicians in 3 Medicare specialties reassign their Medicare billing to Headwaters Health PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (3), Physical Therapist in Private Practice (3) and Family Practice (2). Of these, 5 practice at this address and 7 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Headwaters Health PC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 24D2332057) is associated with this NPI, valid through October 13, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Headwaters Health PC accept?
Health plans from Sanford Health Plan list Headwaters Health PC 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 Headwaters Health PC was last updated on November 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.
# Headwaters Health Pc · NPI 1821976903
Family Medicine organization in Fosston, Minnesota. Organization record, active in the CMS NPPES registry since August 26, 2025.
## Identity
- **NPI:** 1821976903 (Entity type: Organization)
- **Enumerated:** August 26, 2025
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** Cheryl White, MD
## Practice location
- **Address:** 111 2ND ST NE, Fosston, MN 56542-1301
- **Phone:** (218) 435-1111
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 8 clinicians in 3 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (3), Physical Therapist in Private Practice (3), Family Practice (2); 5 practice at this address and 7 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** November 11, 2025
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1821976903) · Data from the CMS NPPES public registry.