NPIMap

Individual provider Active NPI

Laura J Fodness, CNP

  • Family Nurse Practitioner
  • Worthington, MN
National Provider Identifier
1154074649
Registry record updated Feb 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
8746 Issued in MN
Practice address
1216 Ryans Rd
Worthington, MN 56187-1780
Phone
(507) 372-2921
NPI assigned
Feb 3, 2022
Last updated
Feb 3, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2022

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 8746 MN Primary

Addresses

Primary practice location

1216 Ryans Rd
Worthington, MN 56187-1780

Mailing address

117 Oklahoma Ave
Adrian, MN 56110-1143
Phone (507) 227-0821

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220506000617 MN Practitioner - Nurse Practitioner 3779960091 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Avera McKennanGroup PAC ID 0345157103, 957 clinicians
Rural Health Care IncGroup PAC ID 3476447541, 156 clinicians

Practice addresses (Care Compare)

1216 Ryans Rd
Worthington, MN 56187-1722
Phone (507) 372-2921

1216 Ryans Rd
Suite 3
Worthington, MN 56187-1781
Phone (507) 372-6522

941 County Rd
Suite 9
Heron Lake, MN 56137-1408
Phone (507) 793-2349

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8746MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Avera McKennan Current Accepting new patients
Rural Health Care, Inc CurrentSince Mar 28, 2022 Accepting new patients
Rural Health Care, Inc CurrentSince Mar 28, 2022 Accepting new patients
Avera McKennan Past Accepting new patients
Rural Health Care, Inc. Past Accepting new patients

Locations

300 S Bruce St
Ste 100
Marshall, MN 56258

1216 Ryans Rd
Worthington, MN 56187
Phone (507) 372-2921

1216 Ryans Rd
Ste 1
Worthington, MN 56187
Phone (507) 372-2921

1216 Ryans Rd
Ste 3
Worthington, MN 56187
Phone (507) 372-6522

Interoperability endpoints

  • Direct secure messaging: laura.fodness@avera.sdhealthlink.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 26

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

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1643846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643846400000",
    "number": "1154074649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 OKLAHOMA AVE",
            "city": "ADRIAN",
            "state": "MN",
            "postal_code": "561101143",
            "telephone_number": "507-227-0821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1216 RYANS RD",
            "city": "WORTHINGTON",
            "state": "MN",
            "postal_code": "561871780",
            "telephone_number": "507-372-2921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FODNESS",
        "first_name": "LAURA",
        "middle_name": "J",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-03",
        "last_updated": "2022-02-03",
        "certification_date": "2022-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "8746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worthington, MN

Sources for this page

Verify at the official NPI Registry.