Active NPI
Nathaniel Keith Ronning, MD
- Emergency Medicine Physician
- Detroit Lakes, MN
National Provider Identifier
1093941858
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 106565
- Practice address
- 1027 Washington Ave
Detroit Lakes, MN 56501-3409 - Phone
- (218) 847-5611
- Fax
- (218) 847-0881
- NPI assigned
- Jun 8, 2009
- Last updated
- Mar 5, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Emergency Medicine Physician | 207P00000X | ME113927 | FL | |
| Emergency Medicine Physician | 207P00000X | 106565 | MN | Primary |
Addresses
Primary practice location
1027 Washington Ave
Detroit Lakes, MN 56501-3409
Mailing address
1027 Washington Ave
Detroit Lakes, MN 56501-3409
Phone (218) 847-5611
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093941858 | Medicaid | MN |
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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Astera Health
Practice addresses (Care Compare)
415 Jefferson St N
Wadena, MN 56482-1264
Phone (218) 631-7495
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 106565 | MN | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Astera Health | Current | Accepting new patients | |
| Astera Health | Current | Accepting new patients | |
| Ambulatory Care Physicians of Sarasota LLC | Past | Accepting new patients | |
| Sarasota Emergency Associates PA | Emergency Medicine | Past | Accepting new patients |
| Northport Emergency Associates, PA | Past | Accepting new patients |
Locations
415 Jefferson St N
Wadena, MN 56482
Phone (218) 631-3510
Interoperability endpoints
- nronning411730@direct.centracare.com
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- General Practice Physician
- Sarasota, FL
- NPI 1417986084
-
- Emergency Medical Services (Emergency Medicine) Physician
- North Port, FL
- NPI 1881835569
-
- Emergency Medicine Physician
- Sarasota, FL
- NPI 1831175306
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Astera Health Ottertail Clinic
- Rural Health Clinic/Center
- Ottertail, MN
- NPI 1871546663
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1244419200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1362441600000",
"number": "1093941858",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1027 WASHINGTON AVE",
"city": "DETROIT LAKES",
"state": "MN",
"postal_code": "565013409",
"telephone_number": "218-847-5611",
"fax_number": "218-847-0881"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1027 WASHINGTON AVE",
"city": "DETROIT LAKES",
"state": "MN",
"postal_code": "565013409",
"telephone_number": "218-847-5611",
"fax_number": "218-847-0881"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RONNING",
"first_name": "NATHANIEL",
"middle_name": "KEITH",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-06-08",
"last_updated": "2013-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "FL",
"license": "ME113927",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "MN",
"license": "106565",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1093941858",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Detroit Lakes, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2013; 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.