Brenda K Amundson, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

R1462456 Issued in MN

Practice address

1500 Birchmont Dr NE # 42
Bemidji, MN 56601-2600

Phone

(218) 755-2053

Fax

(218) 755-2750

NPI assigned

Aug 12, 2008

Last updated

Apr 4, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Brenda Kay Goeddertz Former name

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

University of North Dakota School of Medicine, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Marys Regional Health CenterGroup PAC ID 2062326820, 190 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Essentia Health St Marys - Detroit Lakes Hospital, Detroit Lakes, MN, CCN 240101
• Essentia Health Hospital, Fargo, ND, CCN 350070

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• St. Marys Regional Health Center

  dba Essentia Health St. Mary's- Detroit Lakes

  • Rural Acute Care Hospital
  • Detroit Lakes, MN
  • NPI 1679561088
  Medicare reassignment Care Compare group
• Altru Health System

  dba Altru Clinic Crookston

  • Clinic/Center
  • Crookston, MN
  • NPI 1760494330
  Medicare reassignment NPD
• Lifecare Medical Center

  • Critical Access Hospital
  • Roseau, MN
  • NPI 1609861095
  Medicare reassignment NPD
• Perham Hospital District

  dba Perham Health

  • Chiropractor
  • Perham, MN
  • NPI 1932113768
  Medicare reassignment NPD
• Lifecare Medical Center

  dba Lifecare Clinic Warroad

  • Rural Health Clinic/Center
  • Warroad, MN
  • NPI 1619724077
  NPD
• Perham Hospital District

  dba Perham Health

  • Family Medicine Physician
  • Perham, MN
  • NPI 1457631814
  NPD
• Perham Hospital District

  • Durable Medical Equipment & Medical Supplies
  • Perham, MN
  • NPI 1558630012
  NPD
• St Mary's Regional Health Center

  dba Essentia Health St. Mary's-Frazee Clinic

  • Rural Health Clinic/Center
  • Frazee, MN
  • NPI 1902364482
  NPD
• St. Mary's Regional Health Center

  dba Essentia Health St. Mary's - Mahnomen Clinic

  • Rural Health Clinic/Center
  • Mahnomen, MN
  • NPI 1750725586
  NPD
• Altru Health System

  dba Altru 1300 Columbia

  • Clinic/Center
  • Grand Forks, ND
  • NPI 1043309552
  NPD
• Altru Health System

  dba Altru Care Flight

  • Ambulance
  • Grand Forks, ND
  • NPI 1114485315
  NPD
• Medexpress Urgent Care Minnesota P.C.

  dba MedExpress Urgent Care - Andover, Bunker Lake Blvd NW

  • Urgent Care Clinic/Center
  • Andover, MN
  • NPI 1669904785
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Mary's Regional Health Center

  dba Essentia Health St. Mary's-Frazee Clinic

  • Rural Health Clinic/Center
  • Frazee, MN
  • NPI 1902364482

  Hospital

  Care Compare affiliation
• St Marys Regional Health Center

  dba Essentia Health Park Rapids Hwy 34 Clinic

  • Rural Health Clinic/Center
  • Park Rapids, MN
  • NPI 1730706656

  Hospital

  Care Compare affiliation
• St. Marys Regional Health Center

  dba Essentia Health St. Mary's- Detroit Lakes

  • Rural Acute Care Hospital
  • Detroit Lakes, MN
  • NPI 1679561088
  Care Compare affiliation
• Innovis Health, LLC

  dba Essentia Health Fargo

  • General Acute Care Hospital
  • Fargo, ND
  • NPI 1215125463
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1218499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712188800000",
    "number": "1013163922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 BIRCHMONT DR NE # 42",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566012600",
            "telephone_number": "218-755-2053",
            "fax_number": "218-755-2750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 BIRCHMONT DR NE # 42",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566012600",
            "telephone_number": "218-755-2053",
            "fax_number": "218-755-2750"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2134 Bunker Lake Blvd NW Ste 100",
            "address_purpose": "LOCATION",
            "city": "Andover",
            "state": "MN",
            "postal_code": "553043910",
            "country_code": "US",
            "telephone_number": "763-754-4396",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AMUNDSON",
        "first_name": "BRENDA",
        "middle_name": "K",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-12",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "R1462456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRENDA",
            "last_name": "GOEDDERTZ",
            "middle_name": "KAY",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Nurse Practitioner in Bemidji, MN
• Providers in Bemidji, MN by specialty
• Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.