Individual provider Active NPI

Danielle Smestad, FNP-BC

  • Family Nurse Practitioner
  • Klamath Falls, OR
National Provider Identifier
1114494705
Registry record updated Aug 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
202004346NP-PP Issued in OR
Practice address
2821 Daggett Ave Ste 200
Klamath Falls, OR 97601-1130
Phone
(541) 274-8400
Fax
(541) 274-8405
NPI assigned
Nov 1, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2020

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 6166 MN
Family Nurse Practitioner 363LF0000X 202004346NP-PP OR Primary

Addresses

Primary practice location

2821 Daggett Ave Ste 200
Klamath Falls, OR 97601-1130

Mailing address

2865 Daggett Ave
Klamath Falls, OR 97601-1106
Phone (541) 274-6311

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, OR2 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
I20181207000645 MN Practitioner - Nurse Practitioner 5597009118 Reassigns benefits to 1 organization
I20200821002071 OR Practitioner - Nurse Practitioner 5597009118 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grand Itasca Clinic and HospitalGroup PAC ID 8123939550, 328 clinicians

Practice addresses (Care Compare)

1601 Golf Course Rd
Grand Rapids, MN 55744-8648
Phone (218) 326-3401

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Grand Itasca Clinic and Hospital CurrentSince Dec 15, 2018 Accepting new patients
Sky Lakes Medical Center Inc CurrentSince Aug 31, 2020 Accepting new patients
Sky Lakes Medical Center Inc CurrentSince Aug 31, 2020 Accepting new patients
Grand Itasca Clinic and Hospital CurrentSince Dec 15, 2018 Accepting new patients

Locations

1601 Golf Course Rd
Grand Rapids, MN 55744
Phone (218) 326-3401

111 SE 3rd St
Grand Rapids, MN 55744
Phone (218) 326-3401

2865 Daggett Ave
Klamath Falls, OR 97601
Phone (541) 833-6221

2821 Daggett Ave
Ste 200
Klamath Falls, OR 97601
Phone (541) 274-8400

Organizations & group practices 4

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.

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": "1541030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597363200000",
    "number": "1114494705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2865 DAGGETT AVE",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976011106",
            "telephone_number": "541-274-6311",
            "fax_number": "541-274-6247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2821 DAGGETT AVE STE 200",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976011130",
            "telephone_number": "541-274-8400",
            "fax_number": "541-274-8405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMESTAD",
        "first_name": "DANIELLE",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-01",
        "last_updated": "2020-08-14",
        "certification_date": "2020-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "6166",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "202004346NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Klamath Falls, OR

Sources for this page

Verify at the official NPI Registry.