Individual provider Active NPI

Alicia M. Glimsdal, APRN, CNP

  • Primary Care Nurse Practitioner
  • Paynesville, MN
National Provider Identifier
1225449192
Registry record updated May 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
657 Issued in MN
Practice address
Centracare Health Paynesville Hospital
200 W 1St St
Paynesville, MN 56362-1445
Phone
(320) 243-3767
Fax
(320) 243-7519
NPI assigned
May 14, 2014
Last updated
May 30, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2019

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 657 MN
Adult Health Nurse Practitioner 363LA2200X R 190448-0 MN
Gerontology Nurse Practitioner 363LG0600X R 190448-0 MN
Gerontology Nurse Practitioner 363LG0600X 657 MN
Primary Care Nurse Practitioner 363LP2300X R 190448-0 MN
Primary Care Nurse Practitioner 363LP2300X 657 MN Primary

Addresses

Primary practice location

Centracare Health Paynesville Hospital
200 W 1St St
Paynesville, MN 56362-1445

Mailing address

Centracare Health Paynesville Hospital
200 W 1St St
Paynesville, MN 56362-1445
Phone (320) 243-3767

Other practice location 1

502 2nd St SW Ste 1
Willmar, MN 56201
Phone (320) 235-7232

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151007002875 MN Practitioner - Nurse Practitioner 8426366675 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Cincinnati College of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centracare ClinicGroup PAC ID 2466363395, 800 clinicians

Practice addresses (Care Compare)

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

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
657MNMDMarriage & Family Therapist
R 190448-0MNMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Centracare Clinic Current Accepting new patients
Centracare Health-Paynesville LLC CurrentSince Nov 26, 2018 Accepting new patients
Centracare Clinic CurrentSince Sep 19, 2024 Accepting new patients
Centracare Clinic CurrentSince Sep 19, 2024 Accepting new patients
Centracare Health-Paynesville LLC CurrentSince Nov 26, 2018 Accepting new patients

Locations

200 W 1st St
Paynesville, MN 56362
Phone (320) 243-3767

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

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

Interoperability endpoints

  • Direct secure messaging: aglimsdal423370@direct.centracare.com

Organizations & group practices 5

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.

Hospital & facility affiliations 9

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": "1400025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559174400000",
    "number": "1225449192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CENTRACARE HEALTH PAYNESVILLE HOSPITAL",
            "address_2": "200 W 1ST ST",
            "city": "PAYNESVILLE",
            "state": "MN",
            "postal_code": "563621445",
            "telephone_number": "320-243-3767",
            "fax_number": "320-243-7519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CENTRACARE HEALTH PAYNESVILLE HOSPITAL",
            "address_2": "200 W 1ST ST",
            "city": "PAYNESVILLE",
            "state": "MN",
            "postal_code": "563621445",
            "telephone_number": "320-243-3767",
            "fax_number": "320-243-7519"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "502 2nd St SW Ste 1",
            "address_purpose": "LOCATION",
            "city": "Willmar",
            "state": "MN",
            "postal_code": "56201",
            "country_code": "US",
            "telephone_number": "320-235-7232",
            "fax_number": "320-231-8602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLIMSDAL",
        "first_name": "ALICIA",
        "middle_name": "M.",
        "name_prefix": "Ms.",
        "credential": "APRN, CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-14",
        "last_updated": "2019-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MN",
            "license": "657",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MN",
            "license": "R 190448-0",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MN",
            "license": "R 190448-0",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MN",
            "license": "657",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MN",
            "license": "R 190448-0",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MN",
            "license": "657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paynesville, MN

Sources for this page

Verify at the official NPI Registry.