Kalie R Drazenovich, CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

7673 Issued in MN

Practice address

1601 Golf Course Rd
Grand Rapids, MN 55744-8648

Phone

(612) 244-5325

NPI assigned

Oct 9, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Grand Itasca Clinic and HospitalGroup PAC ID 8123939550, 328 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tru Healthcare, Inc Home health agency, Arden Hills, MN, CCN 248124

Merit-based Incentive Payment System (MIPS)

Final score

92.35 of 100Reported as group

Quality

88.69

Promoting interoperability

100

Improvement activities

40

Cost

76.65

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kdrazenovich716046@fairview.direct-ci.com

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.

• Grand Itasca Clinic and Hospital

  • General Acute Care Hospital
  • Grand Rapids, MN
  • NPI 1669426631

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Grand Itasca Clinic and Hospital

  • Community/Retail Pharmacy
  • Grand Rapids, MN
  • NPI 1225441157
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Tru Healthcare, Inc.

  • In Home Supportive Care Agency
  • Arden Hills, MN
  • NPI 1982702932

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1602201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748563200000",
    "number": "1063010304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 GOLF COURSE RD",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557448648",
            "telephone_number": "218-326-3401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 GOLF COURSE RD",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557448648",
            "telephone_number": "612-244-5325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRAZENOVICH",
        "first_name": "KALIE",
        "middle_name": "R",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-09",
        "last_updated": "2025-05-30",
        "certification_date": "2025-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "7673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Marie Dolan, L.AC
• Drusilea Donato, LICSW
• Stephanie Lyn Downing
• Lauren G Dozier, FNP
• Taylor Draper, PHD
• Paul Lee Dubbels, O.D.
• Melissa Ann Eiden, RN
• Eldercircle
• Larry Vernon Elj, RN
• Ellen S. Teigland, L.P.,P.a.

• Family Nurse Practitioner in Grand Rapids, MN
• Providers in Grand Rapids, MN by specialty
• Family Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.