Individual provider Active NPI

Marie K Anderson, FNP-C

  • Nurse Practitioner
  • Grafton, ND
National Provider Identifier
1154412518
Registry record updated Feb 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R22236 Issued in ND
Practice address
1113 W 11TH St
Grafton, ND 58237-2139
Phone
(701) 352-4048
Fax
(701) 922-1308
NPI assigned
Sep 28, 2006
Last updated
Feb 27, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R22236 ND Primary

Addresses

Primary practice location

1113 W 11TH St
Grafton, ND 58237-2139

Mailing address

1113 W 11TH St
Grafton, ND 58237-2139
Phone (701) 352-4048

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
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

Enrollment IDStateProvider typePAC IDDetails
I20101012001102 ND Practitioner - Nurse Practitioner 9335331149 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1996
Medicare assignment
May accept Medicare assignment
Group practices
Community Health Service IncGroup PAC ID 4486930195, 7 clinicians

Practice addresses (Care Compare)

1113 W 11TH St
Grafton, ND 58237-2139
Phone (701) 352-4048

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Service Inc. CurrentSince Sep 11, 2023 Accepting new patients
Community Health Service Inc. PastSince Sep 11, 2023 Accepting new patients

Locations

2310 4th Ave N
Moorhead, MN 56560
Phone (218) 236-6502

1113 W 11th St
Grafton, ND 58237
Phone (701) 352-4048

Interoperability endpoints

  • Direct secure messaging: manderson817323@direct.ochin.org

Organizations & group practices 2

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 2

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": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708992000000",
    "number": "1154412518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1113 W 11TH ST",
            "city": "GRAFTON",
            "state": "ND",
            "postal_code": "582372139",
            "telephone_number": "701-352-4048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1113 W 11TH ST",
            "city": "GRAFTON",
            "state": "ND",
            "postal_code": "582372139",
            "telephone_number": "701-352-4048",
            "fax_number": "701-922-1308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "MARIE",
        "middle_name": "K",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2024-02-27",
        "certification_date": "2024-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ND",
            "license": "R22236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grafton, ND

Sources for this page

Verify at the official NPI Registry.