Individual provider Active NPI

Amanda Welke, APRN,CNP

  • Family Nurse Practitioner
  • Duluth, MN
National Provider Identifier
1184075525
Registry record updated Mar 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4864 Issued in MN
Practice address
400 E Third Street
Duluth, MN 55805
Phone
(218) 786-8364
NPI assigned
Jun 27, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R 1617979-1 MN
Family Nurse Practitioner 363LF0000X 4864 MN Primary

Addresses

Primary practice location

400 E Third Street
Duluth, MN 55805

Mailing address

400 E Third Street
Duluth, MN 55805-1951

Other practice location 1

1901 Old Minnesota Ave
Saint Peter, MN 56082-1763
Phone (507) 934-2325 ext. 25206

Other practice location 2

1901 Old Minnesota Ave
Saint Peter, MN 56082-1763
Phone (507) 934-2325 ext. 25206

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R 1617979-1MNMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeview Medical Center Inc of Rice Lake CurrentSince Jan 7, 2020 Accepting new patients
MCHS Hospitals Inc Current Accepting new patients
Planned Parenthood Minnesota, North Dakota, South Dakota CurrentSince Mar 26, 2024 Accepting new patients
Marshfield Clinic Inc CurrentSince Jan 7, 2020 Accepting new patients

Locations

671 Vandalia St
Saint Paul, MN 55114
Phone (651) 696-5674

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

1700 W Stout St
Rice Lake, WI 54868
Phone (715) 236-6133

Interoperability endpoints

  • Direct secure messaging: amanda.welke@marshfieldclinichealthsystem.cernerdirect.com
  • Direct secure messaging: amandawelke@mklt.allscriptsdirect.net

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1466985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551484800000",
    "number": "1184075525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E THIRD STREET",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E THIRD STREET",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "55805",
            "telephone_number": "218-786-8364"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1901 Old Minnesota Ave",
            "address_purpose": "LOCATION",
            "city": "Saint Peter",
            "state": "MN",
            "postal_code": "560821763",
            "country_code": "US",
            "telephone_number": "507-934-2325 x25206",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1901 Old Minnesota Ave",
            "address_purpose": "LOCATION",
            "city": "Saint Peter",
            "state": "MN",
            "postal_code": "560821763",
            "country_code": "US",
            "telephone_number": "507-934-2325 x25206",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WELKE",
        "first_name": "AMANDA",
        "credential": "APRN,CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-27",
        "last_updated": "2019-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "R 1617979-1",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "4864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.