Individual provider Active NPI

Kari Gudmundson

  • Family Nurse Practitioner
  • Grand Forks, ND
National Provider Identifier
1083072466
Registry record updated Jun 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R42729 Issued in ND
Practice address
1451 44TH Ave S Ste F
Grand Forks, ND 58201-3434
Phone
(701) 732-2633
NPI assigned
Feb 1, 2016
Last updated
Jun 22, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4463 MN
Family Nurse Practitioner 363LF0000X R42729 ND Primary

Addresses

Primary practice location

1451 44TH Ave S Ste F
Grand Forks, ND 58201-3434

Mailing address

1451 44TH Ave S Ste F
Grand Forks, ND 58201-3434

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND, MN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160216001631 ND Practitioner - Nurse Practitioner 2567767387 Reassigns benefits to 1 organization
I20161129001535 MN Practitioner - Nurse Practitioner 2567767387 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
First Care Medical ServicesGroup PAC ID 3678542842, shared by 6 NPIs, 22 clinicians
Bridges Medical CenterGroup PAC ID 4981659851, shared by 3 NPIs, 22 clinicians

Practice addresses (Care Compare)

121 Central St W
Bagley, MN 56621-4393
Phone (218) 694-6281

201 9TH St W
Ada, MN 56510-1279

900 Hilligoss Blvd SE
Fosston, MN 56542-1542
Phone (218) 435-1133

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4463MNMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
First Care Medical Services CurrentSince Jul 17, 2023 Accepting new patients
Kidney and Hypertension PLC CurrentSince Oct 3, 2022 Accepting new patients
First Care Medical Services Current Accepting new patients
Family Chiropractic of Warren Inc CurrentSince Jun 19, 2023 Accepting new patients
First Care Medical Services CurrentSince Jul 17, 2023 Accepting new patients
Riverview Healthcare Association Current Accepting new patients
Kidney Institute of North Dakota, LLC Past Accepting new patients

Locations

323 S Minnesota St
Crookston, MN 56716
Phone (218) 281-9200

900 Hilligoss Blvd SE
Fosston, MN 56542
Phone (218) 435-1133

603 N Main St
Warren, MN 56762
Phone (218) 201-3003

4474 23rd Ave S
Ste M
Fargo, ND 58104
Phone (701) 281-3900

5750 S Washington St
Grand Forks, ND 58201
Phone (701) 732-2819

Organizations & group practices 7

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": "1454284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687392000000",
    "number": "1083072466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1451 44TH AVE S STE F",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582013434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1451 44TH AVE S STE F",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582013434",
            "telephone_number": "701-732-2633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUDMUNDSON",
        "first_name": "KARI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-01",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "4463",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ND",
            "license": "R42729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Forks, ND

Sources for this page

Verify at the official NPI Registry.