Individual provider Active NPI

Emma Sheforgen, RD, LD

  • Registered Dietitian
  • Saint Cloud, MN
National Provider Identifier
1184481418
Registry record updated Mar 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Practice address
1200 6TH Ave N
Saint Cloud, MN 56303-2735
Phone
(320) 240-2828
NPI assigned
Mar 4, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X MN Primary

Addresses

Primary practice location

1200 6TH Ave N
Saint Cloud, MN 56303-2735

Mailing address

8987 Ohland Ave NE
Otsego, MN 55330-7192
Phone (763) 221-4335

Other practice location 1

8987 Ohland Ave NE
Otsego, MN 55330-7192
Phone (763) 221-4335

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240402001481 MN Practitioner - Registered Dietitian Or Nutrition Professional 8123466729 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Centracare ClinicGroup PAC ID 2466363395, 800 clinicians

Practice addresses (Care Compare)

1200 6TH Ave N
Saint Cloud, MN 56303-2735

1200 6TH N Ave
Saint Cloud, MN 56303-2735
Phone (320) 252-5131

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Centracare Health System-NR LLC CurrentSince Mar 19, 2024 Accepting new patients
Centracare Clinic Southwest LLC CurrentSince Mar 19, 2024 Accepting new patients
Centracare Health System-NR LLC CurrentSince Mar 19, 2024 Accepting new patients
Centracare Clinic Current Accepting new patients
Centracare Clinic CurrentSince Mar 19, 2024 Accepting new patients
Centracare Clinic CurrentSince Mar 19, 2024 Accepting new patients
Centracare Health System-NR LLC Current Accepting new patients
Centracare Clinic Southwest LLC CurrentSince Mar 19, 2024 Accepting new patients

Locations

1013 Hart Blvd
Monticello, MN 55362
Phone (763) 271-2303

600 Peterson Pkwy
New London, MN 56273
Phone (320) 354-2222

1200 6th Ave N
Saint Cloud, MN 56303
Phone (320) 252-3342

1900 Centracare Cir
Saint Cloud, MN 56303
Phone (320) 252-2422

1604 1st St S
Willmar, MN 56201
Phone (320) 231-5039

Organizations & group practices 8

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": "1709510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709510400000",
    "number": "1184481418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8987 OHLAND AVE NE",
            "city": "OTSEGO",
            "state": "MN",
            "postal_code": "553307192",
            "telephone_number": "763-221-4335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 6TH AVE N",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563032735",
            "telephone_number": "320-240-2828"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8987 Ohland Ave NE",
            "address_purpose": "LOCATION",
            "city": "Otsego",
            "state": "MN",
            "postal_code": "553307192",
            "country_code": "US",
            "telephone_number": "763-221-4335",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHEFORGEN",
        "first_name": "EMMA",
        "credential": "RD, LD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-04",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.