NPIMap

Individual provider Active NPI

Megan Nicole Marlatt Kempf, PA

  • Physician Assistant
  • Brainerd, MN
National Provider Identifier
1154971828
Registry record updated Dec 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
13039 Issued in MN
Practice address
2014 S 6TH St
Brainerd, MN 56401-4529
Phone
(218) 829-7812
Fax
(218) 829-9751
NPI assigned
Sep 16, 2019
Last updated
Dec 26, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 13039 MN Primary

Addresses

Primary practice location

2014 S 6TH St
Brainerd, MN 56401-4529

Mailing address

400 E 3Rd St
Duluth, MN 55805-1951

Other names 1

  • Megan Nicole Marlatt Former name

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
I20190924000760 MN Practitioner - Physician Assistant 8123358850 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Josephs Medical CenterGroup PAC ID 8224948443, 238 clinicians

Practice addresses (Care Compare)

200 Elm St N
Onamia, MN 56359-7901
Phone (320) 532-3154

2014 S 6TH St
Brainerd, MN 56401-4529
Phone (218) 829-7812

2024 S 6TH St
Brainerd, MN 56401-4529
Phone (218) 828-7100

523 N 3Rd St
Brainerd, MN 56401-3054
Phone (218) 828-7394

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
13039MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
St Joseph's Medical Center CurrentSince Nov 11, 2019 Accepting new patients
St Joseph's Medical Center CurrentSince Nov 11, 2019 Accepting new patients
St. Joseph's Medical Center Past Accepting new patients

Locations

2014 S 6th St
Brainerd, MN 56401
Phone (218) 829-7812

523 N 3rd St
Brainerd, MN 56401
Phone (218) 828-7394

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

49725 County 83
Staples, MN 56479
Phone (218) 894-1033

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

Hospital & facility affiliations 11

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": "1568592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577318400000",
    "number": "1154971828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2014 S 6TH ST",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564014529",
            "telephone_number": "218-829-7812",
            "fax_number": "218-829-9751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEMPF",
        "first_name": "MEGAN",
        "middle_name": "NICOLE MARLATT",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-16",
        "last_updated": "2019-12-26",
        "certification_date": "2019-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "13039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEGAN",
            "last_name": "MARLATT",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Brainerd, MN

Sources for this page

Verify at the official NPI Registry.