Kelsey Vivatson, PMHNP-BC, APRN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

R37072 Issued in ND

Practice address

2534 17TH Ave S Ste E
Grand Forks, ND 58201-5215

Phone

(701) 885-4551

Fax

(701) 757-1351

NPI assigned

Jul 20, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

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 and National Provider Directory roles.

• Lifewise Associates LLC

  • Clinic/Center
  • Devils Lake, ND
  • NPI 1871088674

  Multi-Specialty

  Medicare reassignment NPD
• Practice Place, PLLC

  • Clinical Psychologist
  • Grand Forks, ND
  • NPI 1184283541

  Multi-Specialty

  Medicare reassignment NPD

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

{
    "created_epoch": "1658275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758153600000",
    "number": "1043945397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5459",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582065459",
            "telephone_number": "701-885-4551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2534 17TH AVE S STE E",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582015215",
            "telephone_number": "701-885-4551",
            "fax_number": "701-757-1351"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2820 NE 214th St Ste 1002",
            "address_purpose": "LOCATION",
            "city": "Aventura",
            "state": "FL",
            "postal_code": "331801270",
            "country_code": "US",
            "telephone_number": "786-744-4207",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VIVATSON",
        "first_name": "KELSEY",
        "credential": "PMHNP-BC, APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-20",
        "last_updated": "2025-09-18",
        "certification_date": "2025-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ND",
            "license": "R37072",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11019899",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Isabel Theresa Virgille, OD
• Viscito Family Medicine, PLLC
• Vitas Laboratory LLC
• Brittany Marie Vittor, LICSW
• Kelli Ann Vivatson, LRD
• Emily Kay Voeller, M.S., CFY-SLP
• Taylor Volberding
• Andrea Rachelle Volk, M.A, CCC-SLP
• Eden Volk, B MOD SPECIALIST
• Kellye Vonehr

• Psychiatric/Mental Health Nurse Practitioner in Grand Forks, ND
• Providers in Grand Forks, ND by specialty
• Psychiatric/Mental Health Nurse Practitioner in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.