Kathi Margaret Henrickson

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

R-084037-0 Issued in MN

Practice address

2501 Keenan Dr
Essentia Health International Falls Clinic
International Falls, MN 56649-2181

Phone

(218) 283-4481

NPI assigned

Jul 7, 2006

Last updated

May 25, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

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

Specialty

Nurse Practitioner

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Essentia Health Virginia LLCGroup PAC ID 7810149002, 64 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Rainy Lake Medical Center Hospital, International Falls, MN, CCN 241322

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Essentia Health Virginia, LLC

  dba Essentia Health Virginia

  • General Acute Care Hospital
  • Virginia, MN
  • NPI 1083617120
  Medicare reassignment Care Compare group NPD
• The Duluth Clinic LTD

  dba Essentia Health Cloquet Clinic

  • Multi-Specialty Clinic/Center
  • Cloquet, MN
  • NPI 1902563638
  Medicare reassignment NPD
• Essentia Health Virginia, LLC

  dba Essentia Health International Falls Clinic

  • Multi-Specialty Clinic/Center
  • International Falls, MN
  • NPI 1386682045
  NPD
• Essentia Health Virginia, LLC

  dba Essentia Health Ely Clinic

  • Multi-Specialty Clinic/Center
  • Ely, MN
  • NPI 1962440362
  NPD
• The Duluth Clinic, LTD.

  dba Essentia Health Hinckley Pharmacy

  • Community/Retail Pharmacy
  • Hinckley, MN
  • NPI 1245081066
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• International Falls Memorial Hospital Association

  dba Rainy Lake Medical Center

  • Critical Access Hospital
  • International Falls, MN
  • NPI 1528041183
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464134400000",
    "number": "1124050059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 KEENAN DR",
            "address_2": "ESSENTIA HEALTH INTERNATIONAL FALLS CLINIC",
            "city": "INTERNATIONAL FALLS",
            "state": "MN",
            "postal_code": "566492181",
            "telephone_number": "218-283-4481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 KEENAN DR",
            "address_2": "ESSENTIA HEALTH INTERNATIONAL FALLS CLINIC",
            "city": "INTERNATIONAL FALLS",
            "state": "MN",
            "postal_code": "566492181",
            "telephone_number": "218-283-4481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRICKSON",
        "first_name": "KATHI",
        "middle_name": "MARGARET",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2016-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "R-084037-0",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "R-084037-0",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "CNP 2672",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "559177500",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41198600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alan Marc Gorden
• Tammy Marie Gradine, LPC
• Scharazard Lee Gray, M.D.
• Jeffrey Thomas Hardwig
• Tara Helleloid, PHARMD
• Thomas M Herzig, DDS
• Joyce Holliday, OTR
• Shannon Hoshaw, PHARMD
• Independent School District 361
• International Drug Inc

• Psychiatric/Mental Health Nurse Practitioner in International Falls, MN
• Providers in International Falls, MN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2016; 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.

Verify at the official NPI Registry.