Renee Lynn Johnson Kotlarz, CNP, PHN, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

9763 Issued in MN

Practice address

114 Main St N Ste 201B
Hutchinson, MN 55350-1819

Phone

(320) 752-0778

Fax

(320) 753-0779

NPI assigned

Jan 8, 2010

Last updated

Nov 30, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Nystrom and Associates LTDGroup PAC ID 6406752492, 590 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Nystrom & Associates, LTD

  dba Sagent Behavioral Health

  • Clinical Social Worker
  • New Brighton, MN
  • NPI 1396750188
  Medicare reassignment Care Compare group NPD
• McLeod County Public Health

  • Public Health or Welfare Agency
  • Glencoe, MN
  • NPI 1578550190
  NPD (past)

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

{
    "created_epoch": "1262908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669766400000",
    "number": "1205166535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 MAIN ST N STE 201B",
            "city": "HUTCHINSON",
            "state": "MN",
            "postal_code": "553501819",
            "telephone_number": "320-752-0778",
            "fax_number": "320-753-0779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 MAIN ST N STE 201B",
            "city": "HUTCHINSON",
            "state": "MN",
            "postal_code": "553501819",
            "telephone_number": "320-752-0778",
            "fax_number": "320-753-0779"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "520 Chandler Ave N",
            "address_purpose": "LOCATION",
            "city": "Glencoe",
            "state": "MN",
            "postal_code": "553362823",
            "country_code": "US",
            "telephone_number": "320-864-3185",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOTLARZ",
        "first_name": "RENEE",
        "middle_name": "LYNN JOHNSON",
        "credential": "CNP, PHN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-08",
        "last_updated": "2022-11-30",
        "certification_date": "2022-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "9763",
            "primary": true
        },
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "MN",
            "license": "R1378197",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Mary Knudtson, MD
• Joshua Robert Knudtson, M.D.
• Leah J Knutson
• Ann Kosel, PTA
• Amber Rose Kost, BS, MS
• Allison Kay Krause
• Julie A. Krenik, M.D.
• Jennifer Kroon Pesavento, MA, CCC-SLP
• Chelsea Krzmarzick, MA LMFT
• Kent R Kuball, DENTIST

• Psychiatric/Mental Health Nurse Practitioner in Hutchinson, MN
• Providers in Hutchinson, MN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.