Individual provider Active NPI

Kayla Cofer, NURSE PRACTITIONER

  • Nurse Practitioner
  • Bismarck, ND
National Provider Identifier
1023649860
Registry record updated Jun 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R36668 Issued in ND
Practice address
2700 State St
Bismarck, ND 58503-0669
Phone
(701) 712-4520
Fax
(701) 712-4225
NPI assigned
Jan 30, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R36668 ND Primary

Addresses

Primary practice location

2700 State St
Bismarck, ND 58503-0669

Mailing address

2700 State St
Bismarck, ND 58503-0669
Phone (701) 712-4520

Other names 1

  • Kayla Wetzel Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
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

Enrollment IDStateProvider typePAC IDDetails
I20200225001433 ND Practitioner - Nurse Practitioner 9234566647 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Infinity Medical Management LLCGroup PAC ID 4183020555, 10 clinicians

Practice addresses (Care Compare)

310 N 10TH St
Bismarck, ND 58501-4516
Phone (701) 877-2020

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.05 of 100Reported as group
Quality
66.9
Promoting interoperability
95
Improvement activities
40
Cost
80.76

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R36668NDMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Infinity Medical Management LLC CurrentSince Apr 4, 2023 Accepting new patients
Mid Dakota Clinic, Inc. CurrentSince Feb 3, 2020 Accepting new patients

Locations

2700 State St
Bismarck, ND 58503
Phone (701) 221-9152

2700 State St
Ste A2
Bismarck, ND 58503
Phone (701) 712-4500

310 N 10th St
Bismarck, ND 58501
Phone (701) 530-7500

2700 State St
Ste 1
Bismarck, ND 58503
Phone (701) 712-4237

401 N 9th St
Bismarck, ND 58501
Phone (701) 530-6000

3000 32nd Ave S
Fargo, ND 58103
Phone (701) 364-3000

Interoperability endpoints

  • Direct secure messaging: kayla.cofer.1@25999.direct.athenahealth.com

Organizations & group practices 2

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

Hospital & facility affiliations 1

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": "1580342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592784000000",
    "number": "1023649860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 STATE ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585030669",
            "telephone_number": "701-712-4520",
            "fax_number": "701-712-4225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 STATE ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585030669",
            "telephone_number": "701-712-4520",
            "fax_number": "701-712-4225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COFER",
        "first_name": "KAYLA",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-30",
        "last_updated": "2020-06-22",
        "certification_date": "2020-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ND",
            "license": "R36668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAYLA",
            "last_name": "WETZEL",
            "credential": "NURSE PRACTITIONER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bismarck, ND

Sources for this page

Verify at the official NPI Registry.