CROSSOVER HEALTH MEDICAL GROUP
NPI 1861207961
Specialist in West Fargo, ND
NPI Status: Active since February 07, 2025
Contact Information
726 13TH AVE E
WEST FARGO, ND
ZIP 58078
Phone: (844) 398-3640
- Organization
- Specialist
- CLIA Number: 35D2320107
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 03-11-2027
About CROSSOVER HEALTH MEDICAL GROUP
This page provides the complete NPI Profile along with additional information for Crossover Health Medical Group, a provider established in West Fargo, North Dakota operating as a Specialist. The healthcare provider is registered in the NPI registry with number 1861207961 assigned on February 2025. The practitioner's primary taxonomy code is 174400000X. The provider is registered as an organization and their NPI record was last updated one year ago. Crossover Health Medical Group operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The authorized official of this NPI record is Jenette Hunter Cpcs (Sr. Credentialing And Licensing)
- NPI
- 1861207961
- Provider Name
- CROSSOVER HEALTH MEDICAL GROUP
- Entity Type
- Organization
- Location Address
- 726 13TH AVE E WEST FARGO, ND 58078
- Location Phone
- (844) 398-3640
- Mailing Address
- 726 13TH AVE E WEST FARGO, ND 58078
- Mailing Phone
- (844) 398-3640
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 02-07-2025
- Last Update Date
- 02-07-2025
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Specialist
- Taxonomy Code
- 174400000X
- Type
- Other Service Providers
- Taxonomy Description
- An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 35D2320107
- Facility Type
- Physician Office
- Certificate Effective Date
- March 12, 2025
- Certificate Expiration Date
- March 11, 2027
- Laboratory Director
- STEPHEN EZEJI-OKOYE
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Crossover Health Medical Group to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 8 | 6 | 1 | 2 | 0 | 7 | 9 | 6 | 1 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 8 | 12 | 1 | 4 | 0 | 14 | 9 | 12 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 8 + 1 + 2 + 1 + 4 + 0 + 1 + 4 + 9 + 1 + 2 + 24 = 59 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 59 = 1 | 1 | ||||||||
The NPI number 1861207961 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following provider is registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1063062693 | JAEDA KERIN ERTELT FNP-C Individual | Nurse Practitioner (Family) | 726 13TH AVE E WEST FARGO, ND 58078 (844) 398-3640 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1861207961, enumerated in the NPI registry as an "organization" on February 07, 2025
The provider is located at 726 13th Ave E West Fargo, Nd 58078 and the phone number is (844) 398-3640
This medical organization specializes in Specialist with taxonomy code 174400000X
The provider's CLIA number is 35D2320107 for a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..
This NPI record was last updated on February 07, 2025. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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