Cynthia Ann Schackman, ARNP OR PFMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

R1590218 Issued in MN

Practice address

1526 30TH St NW
Bemidji, MN 56601-4140

Phone

(218) 751-0887

Fax

(218) 759-4807

NPI assigned

Oct 10, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL, MN2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Homes Inc.Group PAC ID 0648279554, 7 clinicians

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Cas Psychiatric Services PA

  • Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist
  • Bemidji, MN
  • NPI 1134897663
  Medicare reassignment NPD Authorized official
• North Homes, Inc

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Grand Rapids, MN
  • NPI 1790826550
  Medicare reassignment Care Compare group NPD
• MCR Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Parrish, FL
  • NPI 1255376000
  Medicare reassignment NPD
• MCR Health, Inc.

  • Non-Pharmacy Dispensing Site
  • Bradenton, FL
  • NPI 1821878745
  NPD
• Upper Mississippi Mental Health Center, Inc

  • Community/Behavioral Health Agency
  • Bemidji, MN
  • NPI 1083717334
  NPD (past)
• Centerstone of Florida, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Sarasota, FL
  • NPI 1033789052
  NPD (past)

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747008000000",
    "number": "1154419877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1526 30TH ST NW",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566014140",
            "telephone_number": "218-751-0887",
            "fax_number": "218-759-4807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1526 30TH ST NW",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566014140",
            "telephone_number": "218-751-0887",
            "fax_number": "218-759-4807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHACKMAN",
        "first_name": "CYNTHIA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "ARNP OR PFMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2025-05-12",
        "certification_date": "2025-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "R1590218",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1154419877",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew F Sanford, MD
• Samuel R Sant, O.D.
• Ashok Sapkota, MD
• Alison Lynn Sauer, DDS
• Jack Richard Sauer
• Isabella K Schaefer, LADC
• Kayla Jean Schenheit, MD
• Cody Schepp, DPT
• Heidi Schmitt-Wormley
• Daltin Schmitz, PT

• Psychiatric/Mental Health Nurse Practitioner in Bemidji, MN
• Providers in Bemidji, 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 12, 2025; 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.