Active NPI
Nichole Marie Dorn, APRN
- Family Nurse Practitioner
- Duluth, MN
National Provider Identifier
1144658063
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 6334
- Practice address
- 619 W Central Entrance
Duluth, MN 55811 - Phone
- (218) 249-4987
- Fax
- (218) 249-4989
- NPI assigned
- Oct 31, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 111578 | NE | |
| Family Nurse Practitioner | 363LF0000X | 6334 | MN | Primary |
Addresses
Primary practice location
619 W Central Entrance
Duluth, MN 55811
Mailing address
619 W Central Entrance
Duluth, MN 55811-5448
Phone (218) 249-4987
Other practice location 1
2602 J St
Omaha, NE 68107-1643
Phone (402) 733-3612
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | him@slk.direct.slhduluth.com |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
619 W Central Entrance
Duluth, MN 55811-5448
Phone (218) 249-4987
Hospital & facility affiliations
- St Lukes Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6334 | MN | MD | Dentist |
| 111578 | NE | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Luke'S Hospital of Duluth | Current | Accepting new patients | |
| St. Luke'S Hospital of Duluth | Current | Accepting new patients | |
| St. Luke'S Hospital of Duluth | Current | Accepting new patients | |
| St. Luke'S Hospital of Duluth | Past | Accepting new patients |
Locations
29980 Network Pl
Chicago, IL 60673
619 W Central Entrance
Duluth, MN 55811
Phone (218) 249-4987
915 E 1st St
Duluth, MN 55805
Phone (218) 249-5352
1015 E 1st St
Duluth, MN 55805
Phone (218) 249-7860
4190 Loberg Ave
Hermantown, MN 55811
Phone (218) 249-4600
Interoperability endpoints
- ndorn237242@direct.aspirus.org
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.
-
- Rehabilitation Hospital Unit
- Duluth, MN
- NPI 1902845068
-
- Hospice and Palliative Medicine (Internal Medicine) Physician
- Duluth, MN
- NPI 1073480968
-
- Family Medicine Physician
- Silver Bay, MN
- NPI 1417909557
-
- Family Medicine Physician
- Duluth, MN
- NPI 1306870654
Hospital & facility affiliations 26
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Endocrinology, Diabetes & Metabolism Physician
- Duluth, MN
- NPI 1093769796
Hospital
-
- Vascular & Interventional Radiology Physician
- Duluth, MN
- NPI 1124732110
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1383177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611014400000",
"number": "1144658063",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "619 W CENTRAL ENTRANCE",
"city": "DULUTH",
"state": "MN",
"postal_code": "558115448",
"telephone_number": "218-249-4987",
"fax_number": "218-249-4989"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "619 W CENTRAL ENTRANCE",
"city": "DULUTH",
"state": "MN",
"postal_code": "55811",
"telephone_number": "218-249-4987",
"fax_number": "218-249-4989"
}
],
"practiceLocations": [
{
"address_1": "2602 J St",
"address_purpose": "LOCATION",
"city": "Omaha",
"state": "NE",
"postal_code": "681071643",
"country_code": "US",
"telephone_number": "402-733-3612",
"fax_number": "402-733-3487",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DORN",
"first_name": "NICHOLE",
"middle_name": "MARIE",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-10-31",
"last_updated": "2021-01-19",
"certification_date": "2021-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NE",
"license": "111578",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MN",
"license": "6334",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "him@slk.direct.slhduluth.com",
"affiliation": "N",
"address_1": "619 W Central Entrance",
"city": "Duluth",
"state": "MN",
"country_code": "US",
"postal_code": "55811",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Duluth, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2021; 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.