Individual provider Active NPI

Ronald Halvorson, MD

  • Hematology & Oncology Physician
  • Brainerd, MN
National Provider Identifier
1225012263
Registry record updated Nov 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
34313 Issued in MN
Practice address
9919 Cove Pointe Rd
Brainerd, MN 56401-6179
Phone
(218) 828-7100
NPI assigned
Dec 2, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 34313 MN Primary

Addresses

Primary practice location

9919 Cove Pointe Rd
Brainerd, MN 56401-6179

Mailing address

9919 Cove Pointe Rd
Brainerd, MN 56401-6179
Phone (218) 829-8576

Other identifiers 1

IdentifierTypeStateIssuer
665820200MedicaidMN

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060202000173 MN Practitioner - HematologyPractitioner - Hematology/OncologyPractitioner - Medical Oncology 2668372509 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
3932MNMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Welia Health CurrentSince Feb 2, 2022 Accepting new patients
Cookeville Regional Medical Center CurrentSince Oct 7, 2024 Accepting new patients
Cookeville Regional Medical Center Hematology & Oncology CurrentSince Oct 7, 2024 Accepting new patients
Welia Health CurrentSince Feb 2, 2022 Accepting new patients

Locations

301 Highway 65 S
Mora, MN 55051
Phone (320) 225-3317

140 W 7th St
Cookeville, TN 38501
Phone (931) 783-5582

1 Medical Center Blvd
Cookeville, TN 38501
Phone (931) 783-2334

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": "1133481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730851200000",
    "number": "1225012263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9919 COVE POINTE RD",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564016179",
            "telephone_number": "218-829-8576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9919 COVE POINTE RD",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564016179",
            "telephone_number": "218-828-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALVORSON",
        "first_name": "RONALD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-02",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "MN",
            "license": "34313",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "665820200",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brainerd, MN

Sources for this page

Verify at the official NPI Registry.