Josalyn J Grueneich, APRN,CNP
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · West Fargo, ND
NPI 1093367799 · NPPES record last updated Nov 26, 2024
Key facts
- NPI
- 1093367799
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- R35104 (ND)
- Practice address
- 1401 13TH Ave E
West Fargo, ND 58078-3468 - Phone
- (701) 364-0060
- Fax
- (701) 364-0065
- NPI assigned
- Jul 12, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Knowlton O'Neill and Associates PC
Practice addresses (Care Compare)
1401 13TH Ave E
West Fargo, ND 58078-3402
Phone (701) 364-0060
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ND
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190826002971 | ND | Practitioner - Nurse Practitioner | 5193053361 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R35104 | ND | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Knowlton, O'Neill & Associates, P.C. | Current |
Accepting new patients |
Locations
1401 13th Ave E
West Fargo, ND 58078
Phone (701) 364-0060
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | R35104 | ND | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | R35104 | ND | Yes |
Addresses
Primary practice location
1401 13TH Ave E
West Fargo, ND 58078-3468
Mailing address
1702 University Dr S
Fargo, ND 58103-4940
Other practice location 1
1702 University Dr S
Fargo, ND 58103-4940
Phone (701) 364-3300
Other providers in West Fargo, ND
- Caroline Francis Gravel
- Michael David Greenwood
- Gregory Lowenberg, DC, PC
- Brynna Grimestad
- Janet E Grove
- Aleah Guggisberg
- Anna Gunvalson
- Jason D. Haak
- Susan Ann Haasser
- Erin R Hagen
All providers in West Fargo, ND · Psychiatric/Mental Health Nurse Practitioner in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 26, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.