EVENTIDE (NPI# 1942538608) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942538608 |
| Entity Type | Organization |
| Organization Name | EVENTIDE |
| Practice Address |
125 13th Ave W West Fargo ND 58078-3356 |
| Mailing Address |
1405 7th St S Moorhead MN 56560-3444 |
| Practice Telephone | 7014786000 |
| Practice Fax Number | 7014786001 |
| Mailing Telephone | 2182337508 |
| Mailing Fax Number | 2182333602 |
| Enumeration Date | 2009-11-18 |
| Last Update Date | 2011-04-11 |
| Authorized Official Name | MR. WADE E STUBSON (CFO) |
| Authorized Official Telephone | 2182912216 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487705653 | Eventide | Assisted Living Facility | 1405 7th St S, Moorhead, MN 56560-3444 | 2007-01-15 |
| 1417944265 | Eventide | Custodial Care Facility | 114 S 20th St, Denison, IA 51442-2251 | 2005-10-05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Eventide | 5 Manor House Rd, Littleton, CO 80127 |
| Virginia Business Entities | Eventide Aquaculture Inc. | 3200 Pacific Ave Suite 100, Virginia Beach, Virginia 23451 |
| Massachusetts Corporations | EVENTIDE ARTS, INC. | 713 Main St., Dennis, MA 02638 |
| North Carolina Corporations | Eventide Asset Management LLC | One International Place Suite 3510, Boston, MA 02110 |
| Colorado Business Entities | Eventide Asset Management, LLC | One International Place, Suite 3510, Boston, MA 02110 |
| Oregon Corporations, Companies and Business Names | EVENTIDE ASSET MANAGEMENT, LLC | One International Place, Suite 3510, Boston, MA 02110 |
| Washington State Corporations | EVENTIDE ASSET MANAGEMENT, LLC | 1 International Pl Ste 3510, Boston, MA 02110-2602 |
| Washington State Corporations | EVENTIDE CONSULTING LLC | 7410 Venteian Way, Lake Clarke Shores, FL 33406 |
| Massachusetts Corporations | EVENTIDE ENTERPRISES, INC. | 70 Marstons Ave., Hyannisport, MA 02647 |
| Washington State Corporations | EVENTIDE HEALTH PLLC | 810 Sunday Dr, Friday Harbor, WA 98250-7300 |
| Street Address |
125 13TH AVE W |
| City | WEST FARGO |
| State | ND |
| Zip Code | 58078-3356 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962681452 | Leah Staahl | Physical Therapist | 125 13th Ave W, West Fargo, ND 58078-2646 | 2007-10-31 |
| 1689037731 | Joel Bogenreif | Physical Therapy Assistant | 125 13th Ave W, West Fargo, ND 58078-2646 | 2016-04-05 |
| 1033572243 | Jenny Frantsen | Physical Therapy Assistant | 125 13th Ave W, West Fargo, ND 58078-2646 | 2016-04-04 |
| 1750740445 | Kathy Weir | Physical Therapist | 125 13th Ave W, West Fargo, ND 58078-2646 | 2016-02-23 |
| 1922465269 | Christina Diede | Speech-Language Pathologist | 125 13th Ave W, West Fargo, ND 58078-2646 | 2016-01-18 |
| 1922464882 | Michelle Teresa Parker | Physical Therapist | 125 13th Ave W, West Fargo, ND 58078-2646 | 2016-01-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982205068 | Ashley Kasson Therapy | Counselor | 3220 4th St E, West Fargo, ND 58078 | 2020-11-04 |
| 1427658624 | Deedee (dorin) Ngwe | Technician | 3240 9th S West Apt. 204, West Fargo, ND 58078 | 2020-10-27 |
| 1053879734 | Mpnd,inc | Pharmacy | 2050 Sheyenne Street, West Fargo, ND 58078 | 2019-03-12 |
| 1396239216 | Luke Gable | Behavior Technician | 647 13th Avenue South, West Fargo, ND 58078 | 2018-06-15 |
| 1629597919 | Cody Freng | Specialist/Technologist | 3276 9th St W Apt C, West Fargo, ND 58078 | 2017-09-18 |
| 1831613942 | Lauren Phyllis Loe | Physical Therapist | 1401 13th Avenue East, Essentia Health West Fargo Clinic, West Fargo, ND 58078 | 2017-07-31 |
| 1851746226 | Jodi Kilen | Occupational Therapy Assistant | 631 4th Ave East, West Fargo, ND 58078 | 2016-05-04 |
| 1922490101 | Betty Ann Helmer | Social Worker | 2355 Meadow Ridge Parkway, West Fargo, ND 58078 | 2015-02-25 |
| 1477972784 | Tessa Nicole Larson | Occupational Therapist | 3139 Bluestem Dr Ste 108, West Fargo, ND 58078 | 2014-04-15 |
| 1023432010 | Kaylyn Kortes | Licensed Practical Nurse | 1302 Sheyenne St, West Fargo, ND 58078 | 2014-02-11 |
| Find all providers in zip 58078 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760033997 | Oluwakemi Isokpan | Skilled Nursing Facility | 1323 Legion Ln W, West Fargo, ND 58078-8523 | 2019-09-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164809562 | Eventide Fargo LLC | Skilled Nursing Facility | 3225 51st St S, Fargo, ND 58104-7180 | 2015-05-05 |
| 1841691789 | Tufte Manor | Skilled Nursing Facility | 3300 Cherry St, Grand Forks, ND 58201-7634 | 2014-09-10 |
| 1861745838 | Benedictine Living Community of Wahpeton | Skilled Nursing Facility | 711 14th Avenue North, Wahpeton, ND 58075 | 2012-10-16 |
| 1215256078 | Eventide Jamestown LLC | Skilled Nursing Facility | 1300 2nd Pl Ne, Jamestown, ND 58401-3709 | 2010-05-19 |
| 1427371889 | Benedictine Living Communities-bismarck, Inc. | Skilled Nursing Facility | 4580 Coleman Street, Bismarck, ND 58503-0347 | 2010-03-12 |
| 1508197013 | The Evangelical Lutheran Good Samaritan Society | Skilled Nursing Facility | 301 Lorrain Dr, Bismarck, ND 58503-0311 | 2010-01-22 |
| 1144485608 | Villa Maria | Skilled Nursing Facility | 3102 University Dr S, Fargo, ND 58103-6004 | 2008-07-24 |
| 1477737625 | Pat Sitzer | Skilled Nursing Facility | 751 1st St., Pat Sizer, Minto, ND 58261 | 2007-12-24 |
| 1205041985 | Benedictine Living Center of Garrison | Skilled Nursing Facility | 609 Fourth Ave Ne, Garrison, ND 58540-0219 | 2007-05-14 |
| 1811039316 | Dunseith Community Nursing Home | Skilled Nursing Facility | 15 First St Ne, Dunseith, ND 58329 | 2007-02-12 |
| Find all providers with the same taxonomy | ||||
| City | WEST FARGO |
| Zip Code | 58078 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.