Individual provider Active NPI

Brynn Lara Charlesworth, M.D.

  • Family Medicine Physician
  • Crookston, MN
National Provider Identifier
1124751912
Registry record updated Sep 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
77694 Issued in MN
Practice address
400 S. Minnesota St
Crookston, MN 56716
Phone
(218) 281-9100
NPI assigned
Jul 8, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 18744 ND
Family Medicine Physician 207Q00000X 77694 MN Primary

Addresses

Primary practice location

400 S. Minnesota St
Crookston, MN 56716

Mailing address

PO Box 13780
Grand Forks, ND 58208
Phone (701) 780-1891

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND, MN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250829004515 ND Practitioner - Family Practice 1759764889 Reassigns benefits to 1 organization
I20250901000138 MN Practitioner - Family Practice 1759764889 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Altru Health SystemGroup PAC ID 1355251604, 675 clinicians

Practice addresses (Care Compare)

1380 S Columbia Rd
Grand Forks, ND 58201-4059
Phone (701) 795-2000

1845 Hwy 59 S
Thief River Falls, MN 56701-4318
Phone (218) 681-7280

400 S Minnesota St
Crookston, MN 56716-1808
Phone (218) 281-9100

Hospital & facility affiliations

  • Altru Hospital Hospital, Grand Forks, ND, CCN 350019
  • Sanford Thief River Falls Medical Center Hospital, Thief River Falls, MN, CCN 241381

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
18744NDMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Altru Health System CurrentSince Sep 1, 2025 Accepting new patients
Altru Health System CurrentSince Sep 1, 2025 Accepting new patients
Altru Health System CurrentSince Sep 1, 2025 Accepting new patients
Altru Health System Current Accepting new patients
Altru Health System Family Medicine Current Accepting new patients

Locations

400 S Minnesota St
Crookston, MN 56716
Phone (218) 281-9100

1380 S Columbia Rd
Grand Forks, ND 58201
Phone (701) 795-2000

725 Hamline St
Grand Forks, ND 58203
Phone (701) 777-6800

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1657238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758240000000",
    "number": "1124751912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13780",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "58208",
            "telephone_number": "701-780-1891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S. MINNESOTA ST",
            "city": "CROOKSTON",
            "state": "MN",
            "postal_code": "56716",
            "telephone_number": "218-281-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARLESWORTH",
        "first_name": "BRYNN",
        "middle_name": "LARA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-08",
        "last_updated": "2025-09-19",
        "certification_date": "2025-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ND",
            "license": "18744",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "77694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crookston, MN

Sources for this page

Verify at the official NPI Registry.