Individual provider Active NPI

Nancy Lynn Pesta Walsh, FNP-BC

  • Family Nurse Practitioner
  • Faribault, MN
National Provider Identifier
1093982837
Registry record updated May 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R 126866-3 Issued in MN
Practice address
200 State Ave
Faribault, MN 55021-6339
Phone
(507) 334-6451
NPI assigned
May 12, 2008
Last updated
May 14, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R 126866-3 MN Primary

Addresses

Primary practice location

200 State Ave
Faribault, MN 55021-6339

Mailing address

201 N Ridge Dr
Kenyon, MN 55946-1532
Phone (507) 789-6883

Other practice location 1

1125 6th St SE
Willmar, MN 56201-4675
Phone (320) 235-4613

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081014000765 MN Practitioner - Nurse Practitioner 8921166216 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hutchinson HealthGroup PAC ID 0345330072, 145 clinicians
Woodland CentersGroup PAC ID 7416860457, 39 clinicians
Glacial Ridge Hospital DistrictGroup PAC ID 5294789194, shared by 7 NPIs, 69 clinicians

Practice addresses (Care Compare)

1029 Hwy 15 S
Hutchinson, MN 55350-3153
Phone (320) 484-4400

1071 Hwy 15 S
Hutchinson, MN 55350-3153
Phone (320) 484-4610

1125 SE 6TH St
Willmar, MN 56201-4675
Phone (320) 235-4613

3 Century Ave SE
Hutchinson, MN 55350-3108
Phone (320) 234-3290

417 Franklin St S
Glenwood, MN 56334-1518
Phone (320) 634-5157

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R 126866-3MNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hutchinson Health CurrentSince Jan 1, 2013 Accepting new patients
Glacial Ridge Hospital District CurrentSince Mar 1, 2020 Accepting new patients
Glacial Ridge Hospital District Current Accepting new patients
Woodland Centers CurrentSince Jun 15, 2021 Accepting new patients
Glacial Ridge Hospital District Current Accepting new patients
Glacial Ridge Hospital District CurrentSince Mar 1, 2020 Accepting new patients
Glacial Ridge Hospital District Past Accepting new patients

Locations

111 Pleasant Ave N
#69
Brooten, MN 56316

10 4th Ave SE
Glenwood, MN 56334
Phone (320) 634-5157

417 Franklin St S
Glenwood, MN 56334
Phone (320) 634-5157

1029 Highway 15 S
Hutchinson, MN 55350
Phone (320) 275-3358

3 Century Ave SE
Hutchinson, MN 55350
Phone (320) 234-3290

1125 6th St SE
Willmar, MN 56201
Phone (320) 231-9148

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/glac-1755385c

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": "1210550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620950400000",
    "number": "1093982837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 N RIDGE DR",
            "city": "KENYON",
            "state": "MN",
            "postal_code": "559461532",
            "telephone_number": "507-789-6883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 STATE AVE",
            "city": "FARIBAULT",
            "state": "MN",
            "postal_code": "550216339",
            "telephone_number": "507-334-6451"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1125 6th St SE",
            "address_purpose": "LOCATION",
            "city": "Willmar",
            "state": "MN",
            "postal_code": "562014675",
            "country_code": "US",
            "telephone_number": "320-235-4613",
            "fax_number": "855-625-7406",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PESTA WALSH",
        "first_name": "NANCY",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-12",
        "last_updated": "2021-05-14",
        "certification_date": "2021-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "R 126866-3",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Faribault, MN

Sources for this page

Verify at the official NPI Registry.