Individual provider Active NPI

Kayla Clausen, FNP-C

  • Family Nurse Practitioner
  • Grand Forks, ND
National Provider Identifier
1023504073
Registry record updated Jun 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R37799 Issued in ND
Practice address
960 S Columbia Rd
Grand Forks, ND 58201-4030
Phone
(701) 780-5400
Fax
(701) 780-6416
NPI assigned
Jul 2, 2018
Last updated
Jun 18, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R37799 ND Primary

Addresses

Primary practice location

960 S Columbia Rd
Grand Forks, ND 58201-4030

Mailing address

2401 Demers Ave
Grand Forks, ND 58201-4183
Phone (701) 780-5000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address knotbohm67311@direct.directaltru.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND, MN2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20180822003364 ND Practitioner - Nurse Practitioner 1153670237 Reassigns benefits to 1 organization
I20190103003328 MN Practitioner - Nurse Practitioner 1153670237 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of North Dakota School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Altru Health SystemGroup PAC ID 1355251604, shared by 14 NPIs, 675 clinicians

Practice addresses (Care Compare)

1200 S Columbia Rd
Grand Forks, ND 58201-4036
Phone (701) 780-5000

400 S Minnesota St
Crookston, MN 56716-1808
Phone (218) 281-9100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R37799NDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Altru Health System Current Accepting new patients
Altru Health System CurrentSince Jul 9, 2018 Accepting new patients
Altru Health System CurrentSince Jul 9, 2018 Accepting new patients
Altru Health System Current Accepting new patients
Altru Health System CurrentSince Nov 18, 2018 Accepting new patients
Christian Unity Hospital Corporation Past Accepting new patients
Altru Health System Past Accepting new patients

Locations

400 S Minnesota St
Crookston, MN 56716
Phone (218) 281-9100

607 Demers Ave
East Grand Forks, MN 56721
Phone (218) 773-0357

19120 200th St
Greenbush, MN 56726
Phone (218) 782-2400

711 Delmore Dr
Roseau, MN 56751
Phone (218) 463-1365

412 Main Ave NE
Warroad, MN 56763
Phone (218) 386-2020

164 W 13th St
Grafton, ND 58237
Phone (701) 352-1620

1200 S Columbia Rd
Grand Forks, ND 58201
Phone (701) 780-5243

1380 S Columbia Rd
Grand Forks, ND 58201
Phone (701) 795-2000

2401 Demers Ave
Grand Forks, ND 58201
Phone (701) 780-1891

960 S Columbia Rd
Grand Forks, ND 58201
Phone (701) 780-5400

901 2nd St
Langdon, ND 58249
Phone (701) 256-6100

301 5th St
Walhalla, ND 58282
Phone (701) 549-2711

Organizations & group practices 7

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 5

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": "1530489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592438400000",
    "number": "1023504073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 DEMERS AVE",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582014183",
            "telephone_number": "701-780-5000",
            "fax_number": "701-780-4477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 S COLUMBIA RD",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582014030",
            "telephone_number": "701-780-5400",
            "fax_number": "701-780-6416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLAUSEN",
        "first_name": "KAYLA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-02",
        "last_updated": "2020-06-18",
        "certification_date": "2020-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ND",
            "license": "R37799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "knotbohm67311@direct.directaltru.org",
            "affiliation": "N",
            "endpointDescription": "Direct mail",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "960 S Columbia Rd",
            "city": "Grand Forks",
            "state": "ND",
            "country_code": "US",
            "postal_code": "582014030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Grand Forks, ND

Sources for this page

Verify at the official NPI Registry.