Individual provider Active NPI

Renee R Small, NP

  • Nurse Practitioner
  • Bismarck, ND
National Provider Identifier
1194821355
Registry record updated Jan 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R23515 Issued in ND
Practice address
222 N 7TH St
Bismarck, ND 58501-4436
Phone
(701) 323-6000
Fax
(701) 323-5883
NPI assigned
Sep 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R23515 ND Primary

Addresses

Primary practice location

222 N 7TH St
Bismarck, ND 58501-4436

Mailing address

PO Box 5501
Bismarck, ND 58506-5501
Phone (701) 323-6000

Other identifiers 1

IdentifierTypeStateIssuer
19711MedicaidND

Other names 1

  • Renee R Kraft Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
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
I20031209000781 ND Practitioner - Nurse Practitioner 0648176867 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanford BismarckGroup PAC ID 9739098575, 562 clinicians

Practice addresses (Care Compare)

515 E Broadway Ave
Sanford 5TH and Broadway Clinic
Bismarck, ND 58801-4407
Phone (701) 323-5631

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.63 of 100Reported as group
Quality
89.39
Promoting interoperability
100
Improvement activities
40
Cost
76.04

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Bismarck CurrentSince Aug 8, 2002 Accepting new patients
Sanford Bismarck Current Accepting new patients
Medcenter One Health Systems DME Current Accepting new patients
Sanford Bismarck CurrentSince Aug 8, 2002 Accepting new patients

Locations

222 N 7th St
Bismarck, ND 58501
Phone (701) 323-5422

515 E Broadway Ave
Bismarck, ND 58501
Phone (701) 323-5324

3318 N 14th St
Bismarck, ND 58503
Phone (701) 323-8300

515 E Broadway
Unit 5
Williston, ND 58801
Phone (701) 323-5631

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.

Hospital & facility affiliations 3

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": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294790400000",
    "number": "1194821355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5501",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585065501",
            "telephone_number": "701-323-6000",
            "fax_number": "701-323-5709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 N 7TH ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585014436",
            "telephone_number": "701-323-6000",
            "fax_number": "701-323-5883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMALL",
        "first_name": "RENEE",
        "middle_name": "R",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-15",
        "last_updated": "2011-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ND",
            "license": "R23515",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "19711",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RENEE",
            "last_name": "KRAFT",
            "middle_name": "R",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bismarck, ND

Sources for this page

Verify at the official NPI Registry.