Individual provider Active NPI

Beth Fladhammer, CNP

  • Family Nurse Practitioner
  • Minneapolis, MN
National Provider Identifier
1053867333
Registry record updated Dec 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CNP4784 Issued in MN
Practice address
121 Washington Ave N FL 2
Minneapolis, MN 55401-1619
Phone
(888) 731-8994
NPI assigned
Aug 28, 2016
Last updated
Dec 3, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X CNP4784 MN
Family Nurse Practitioner 363LF0000X CNP4784 MN Primary

Addresses

Primary practice location

121 Washington Ave N FL 2
Minneapolis, MN 55401-1619

Mailing address

121 Washington Ave N FL 2
Minneapolis, MN 55401-1619
Phone (320) 839-6157

Other identifiers 1

IdentifierTypeStateIssuer
1053867333MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20161007000012 MN Practitioner - Nurse Practitioner 1254629280

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

450 Eastvold Ave
Ortonville, MN 56278-1252

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.21 of 100Reported as group
Quality
92.56
Promoting interoperability
100
Improvement activities
40
Cost
41.48

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
CNP4784MNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ortonville Area Health Services CurrentSince Sep 19, 2016 Accepting new patients
Ortonville Area Health Services CurrentSince Sep 19, 2016 Accepting new patients
Ortonville Area Health Services Current Accepting new patients
Ortonville Area Health Services Past Accepting new patients

Locations

450 Eastvold Ave
Ortonville, MN 56278
Phone (320) 839-2502

Organizations & group practices 4

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 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": "1472342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764720000000",
    "number": "1053867333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 WASHINGTON AVE N FL 2",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554011619",
            "telephone_number": "320-839-6157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 WASHINGTON AVE N FL 2",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554011619",
            "telephone_number": "888-731-8994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLADHAMMER",
        "first_name": "BETH",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-28",
        "last_updated": "2025-12-03",
        "certification_date": "2025-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "CNP4784",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "CNP4784",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1053867333",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.