Individual provider Active NPI

Shaina Rae Watson, APRN, NP-C

  • Nurse Practitioner
  • Albert Lea, MN
National Provider Identifier
1154883346
Registry record updated Oct 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
6522 Issued in MN
Practice address
404 W Fountain St
Albert Lea, MN 56007-2437
Phone
(507) 373-2384
NPI assigned
Apr 5, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 6522 MN Primary
Family Medicine Physician 207Q00000X 6522 MN

Addresses

Primary practice location

404 W Fountain St
Albert Lea, MN 56007-2437

Mailing address

200 1St St SW
Rochester, MN 55905-0001
Phone (507) 284-2511

Other names 1

  • Shaina Rae Archer Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sweis89722@ehrdirect.mayoclinicmsg.org

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190625001957 MN Practitioner - Nurse Practitioner 9638403611 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mayo Clinic Health System-Southeast Minnesota RegionGroup PAC ID 4385556703, 550 clinicians

Practice addresses (Care Compare)

404 W Fountain St
Albert Lea, MN 56007-2437
Phone (507) 373-2384

Hospital & facility affiliations

  • Mayo Clinic Health System - Albert Lea and Austin Hospital, Albert Lea, MN, CCN 240043

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Health System-Southeast Minnesota Region CurrentSince Jul 10, 2019 Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region Current Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region CurrentSince Jul 10, 2019 Accepting new patients

Locations

404 W Fountain St
Albert Lea, MN 56007
Phone (507) 377-6285

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

Interoperability endpoints

  • Direct secure messaging: sweis89722@ehrdirect.mayoclinicmsg.org

Organizations & group practices 3

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 1

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": "1554422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698019200000",
    "number": "1154883346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "507-284-2511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 W FOUNTAIN ST",
            "city": "ALBERT LEA",
            "state": "MN",
            "postal_code": "560072437",
            "telephone_number": "507-373-2384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "SHAINA",
        "middle_name": "RAE",
        "credential": "APRN, NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-05",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "6522",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "6522",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sweis89722@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "404 W Fountain St",
            "city": "Albert Lea",
            "state": "MN",
            "country_code": "US",
            "postal_code": "560072437",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SHAINA",
            "last_name": "ARCHER",
            "middle_name": "RAE",
            "credential": "APRN, NP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Albert Lea, MN

Sources for this page

Verify at the official NPI Registry.