Individual provider Active NPI

Kathleen Marie Grangaard, FNP

  • Nurse Practitioner
  • La Crosse, WI
National Provider Identifier
1023398971
Registry record updated Sep 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5094 Issued in WI
Practice address
700 West Ave S
La Crosse, WI 54601-4783
Phone
(608) 785-0940
NPI assigned
Aug 24, 2011
Last updated
Sep 15, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1682773 MN
Nurse Practitioner 363L00000X 6104 MN
Nurse Practitioner 363L00000X 5094 WI Primary
Family Nurse Practitioner 363LF0000X A106975 IA

Addresses

Primary practice location

700 West Ave S
La Crosse, WI 54601-4783

Mailing address

PO Box 1510
Eau Claire, WI 54702-1510
Phone (608) 785-0940

Other practice location 1

701 N Sprague St
Caledonia, MN 55921-1066
Phone (507) 724-3353

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kgrangaard28022@ehrdirect.mayoclinicmsg.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, WI, MN3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20110921000662 IA Practitioner - Nurse Practitioner 4688845787 Reassigns benefits to 4 organizations
I20121126000383 WI Practitioner - Nurse Practitioner 4688845787 Reassigns benefits to 3 organizations
I20181106003201 MN Practitioner - Nurse Practitioner 4688845787 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Veterans Memorial Hospital City of Waukon IaGroup PAC ID 1355230293, shared by 6 NPIs, 40 clinicians
Mayo Clinic Health System-Southwest Wisconsin Region IncGroup PAC ID 0345152443, shared by 9 NPIs, 539 clinicians

Practice addresses (Care Compare)

105 E Main St
Waukon, IA 52172-1735
Phone (563) 568-5530

124 W Greene St
Postville, IA 52162-7772
Phone (563) 864-7221

191 Theater Rd
Onalaska, WI 54650-8679
Phone (608) 392-5000

800 E Blackhawk Ave
Prairie Du Chien, WI 53821-1698
Phone (608) 326-0808

825 Mankato Ave
Winona, MN 55987-4866
Phone (507) 457-4149

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1682773MNMDNurse Practitioner
5094WIMDNurse Practitioner
A106975IAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gundersen Lutheran Express Care, Inc CurrentSince Sep 12, 2011 Accepting new patients
Veterans Memorial Hospital City of Waukon Ia Current Accepting new patients
Veterans Memorial Hospital City of Waukon Ia CurrentSince Mar 30, 2022 Accepting new patients
Veterans Memorial Hospital City of Waukon Ia CurrentSince Mar 30, 2022 Accepting new patients
Prairie Du Chien Memorial Hospital Association Inc CurrentSince Jul 1, 2019 Accepting new patients
Mayo Clinic Health System-Southwest Wisconsin Region, Inc. CurrentSince Oct 12, 2012 Accepting new patients
Mayo Clinic Health System-Southwest Wisconsin Region, Inc. Current Accepting new patients
Gundersen Clinic LTD CurrentSince Sep 12, 2011 Accepting new patients
Mayo Clinic Health System-Southwest Wisconsin Region, Inc. CurrentSince Oct 12, 2012 Accepting new patients

Locations

901 Montgomery St
Decorah, IA 52101
Phone (319) 382-2911

105 E Main St
Waukon, IA 52172
Phone (319) 568-3449

40 1st St SE
Waukon, IA 52172
Phone (563) 568-3411

701 N Sprague St
Caledonia, MN 55921
Phone (507) 724-3353

825 Mankato Ave
Winona, MN 55987
Phone (507) 454-4925

700 West Ave S
La Crosse, WI 54601
Phone (608) 791-4156

800 West Ave S
La Crosse, WI 54601
Phone (608) 372-5951

37868 US Highway 18
Prairie du Chien, WI 53821
Phone (608) 357-2000

705 E Taylor St
Prairie du Chien, WI 53821
Phone (608) 357-2000

800 E Blackhawk Ave
Prairie du Chien, WI 53821
Phone (608) 326-0808

310 W Main St
Sparta, WI 54656
Phone (608) 269-1700

Organizations & group practices 9

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1314144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600128000000",
    "number": "1023398971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1510",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547021510",
            "telephone_number": "608-785-0940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 WEST AVE S",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546014783",
            "telephone_number": "608-785-0940"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 N Sprague St",
            "address_purpose": "LOCATION",
            "city": "Caledonia",
            "state": "MN",
            "postal_code": "559211066",
            "country_code": "US",
            "telephone_number": "507-724-3353",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRANGAARD",
        "first_name": "KATHLEEN",
        "middle_name": "MARIE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-24",
        "last_updated": "2020-09-15",
        "certification_date": "2020-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "1682773",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "6104",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "5094",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A106975",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kgrangaard28022@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "700 West Ave S",
            "city": "LA Crosse",
            "state": "WI",
            "country_code": "US",
            "postal_code": "546014783",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in La Crosse, WI

Sources for this page

Verify at the official NPI Registry.