Active NPI
Danette Lee Diethert, PMHNP
- Psychiatric/Mental Health Nurse Practitioner
- Brainerd, MN
National Provider Identifier
1083014385
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- R-104601-4
- Practice address
- 523 N 3Rd St
Brainerd, MN 56401-3054 - Phone
- (218) 829-2861
- Fax
- (218) 828-3130
- NPI assigned
- Aug 25, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | R-104601-4 | MN | Primary |
Addresses
Primary practice location
523 N 3Rd St
Brainerd, MN 56401-3054
Mailing address
523 N 3Rd St
Brainerd, MN 56401-3054
Phone (218) 829-2861
Other names 1
- Danette Lee Christianson
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
523 N 3Rd St
Brainerd, MN 56401-3054
Phone (218) 829-2861
Hospital & facility affiliations
- Essentia Health St Joseph'S Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R-104601-4 | MN | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Joseph'S Medical Center | Current | Accepting new patients | |
| St. Joseph'S Medical Center | Current | Accepting new patients | |
| St. Joseph'S Medical Center | Current | Accepting new patients | |
| Brainerd Medical Center Inc | Current | Accepting new patients | |
| Brainerd Medical Center Inc. | Current | Accepting new patients |
Locations
523 N 3rd St
Brainerd, MN 56401
Phone (218) 828-7394
13060 Isle Dr
Brainerd, MN 56425
Phone (218) 454-5920
2024 S 6th St
Brainerd, MN 56401
Phone (218) 828-2880
400 E 3rd St
#2
Duluth, MN 55805
Phone (218) 786-8319
Organizations & group practices 5
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.
-
- General Acute Care Hospital
- Brainerd, MN
- NPI 1568415974
-
- General Practice Physician
- Brainerd, MN
- NPI 1295801777
-
- Clinic Pharmacy
- Staples, MN
- NPI 1972350486
-
- Multi-Specialty Clinic/Center
- Staples, MN
- NPI 1538916101
-
- Primary Care Clinic/Center
- Pequot Lakes, MN
- NPI 1730134891
Hospital & facility affiliations 10
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Brainerd, MN
- NPI 1568415974
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Brainerd, MN
- NPI 1740393032
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1408924800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1452124800000",
"number": "1083014385",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "523 N 3RD ST",
"city": "BRAINERD",
"state": "MN",
"postal_code": "564013054",
"telephone_number": "218-829-2861"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "523 N 3RD ST",
"city": "BRAINERD",
"state": "MN",
"postal_code": "564013054",
"telephone_number": "218-829-2861",
"fax_number": "218-828-3130"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIETHERT",
"first_name": "DANETTE",
"middle_name": "LEE",
"credential": "PMHNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-08-25",
"last_updated": "2016-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "MN",
"license": "R-104601-4",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "DANETTE",
"last_name": "CHRISTIANSON",
"middle_name": "LEE",
"credential": "RN",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Brainerd, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2016; 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.