Annalise Medeles

Primary specialty

SpecialistTaxonomy code 174400000X

Practice address

418 3Rd St NW
East Grand Forks, MN 56721-1713

Phone

(218) 287-4338

NPI assigned

Jul 30, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Annalise Gruber Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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 and National Provider Directory roles.

• Anne Carlsen Center

  • Physical Therapist
  • Jamestown, ND
  • NPI 1598930109

  Behavior Technician

  NPD
• Anne Carlsen Center

  • Community/Behavioral Health Agency
  • Jamestown, ND
  • NPI 1659966877
  NPD (past)

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

{
    "created_epoch": "1722297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783641600000",
    "number": "1043049901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1547 30TH AVE S",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565605149",
            "telephone_number": "218-287-4338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "418 3RD ST NW",
            "city": "EAST GRAND FORKS",
            "state": "MN",
            "postal_code": "567211713",
            "telephone_number": "218-287-4338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDELES",
        "first_name": "ANNALISE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-30",
        "last_updated": "2026-07-10",
        "certification_date": "2026-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNALISE",
            "last_name": "GRUBER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Renee Louise Mabey, PHD, PT
• Sarah My Trang Mabey
• Marcia Mack
• Troy Anthony Magsam
• Haille McLaughlin
• Richard Morgan, DPT
• Patricia Motl, PHARMD, RPH
• Hannah Hillis Nelson
• Melanie Mae Nelson, SLP
• Chukwuka Oscar Nnoli, PA-C

• Specialist in East Grand Forks, MN
• Providers in East Grand Forks, MN by specialty
• Specialist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.