Active NPI
Kristin Elisabeth Dearruda Wharton, APRN, FNP-C
- Family Nurse Practitioner
- Grand Marais, MN
National Provider Identifier
1245876614
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 7075
- Practice address
- 513 5TH Ave W
Grand Marais, MN 55604-3017 - Phone
- (183) 872-3302
- NPI assigned
- Nov 20, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 7075 | MN | Primary |
Addresses
Primary practice location
513 5TH Ave W
Grand Marais, MN 55604-3017
Mailing address
513 5TH Ave W
Grand Marais, MN 55604-3017
Phone (183) 872-3302
Other practice location 1
915 E 1st St
Duluth, MN 55805-2107
Phone (218) 249-5555
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7075 | Other | MN | MINNESOTA BOARD OF NURSING- APRN LICENSE |
| 11185596 | Other | INTERNATIONAL BOARD OF LACTATION CONSULTANT EXAMINERS | |
| 16274 | Other | MN | MINNESOTA BOARD OF NURSING- PUBLIC HEALTH NURSE |
| 169220-0 | Other | MN | MINNESOTA BOARD OF NURSING |
| F09191840 | Other | AMERICAN ACADEMY OF NURSE PRACTITIONERS |
Other names 1
- Kristin Elisabeth Dearruda
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | him@slk.direct.slhduluth.com |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
513 5TH Ave W
Grand Marais, MN 55604-3017
Phone (218) 387-2330
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7075 | MN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northern Pines Medical Center | Current | Accepting new patients | |
| Sawtooth Mountain Clinic, Inc. | Current | Accepting new patients | |
| Northern Pines Medical Center | Current | Accepting new patients |
Locations
5211 Highway 110
Aurora, MN 55705
Phone (218) 229-1010
513 5th Ave W
Grand Marais, MN 55604
Phone (218) 387-2330
Interoperability endpoints
- kdearrudawharton815108@direct.ochin.org
Organizations & group practices 3
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.
-
- Federally Qualified Health Center (FQHC)
- Grand Marais, MN
- NPI 1306832894
-
- Critical Access Hospital
- Aurora, MN
- NPI 1639278609
-
- Rural Health Clinic/Center
- Aurora, MN
- NPI 1285183046
Hospital & facility affiliations 29
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Grand Marais, MN
- NPI 1487712493
-
- General Acute Care Hospital
- Duluth, MN
- NPI 1457393035
-
- Endocrinology, Diabetes & Metabolism Physician
- Duluth, MN
- NPI 1093769796
Hospital
-
- Vascular & Interventional Radiology Physician
- Duluth, MN
- NPI 1124732110
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1574208000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718236800000",
"number": "1245876614",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "513 5TH AVE W",
"city": "GRAND MARAIS",
"state": "MN",
"postal_code": "556043017",
"telephone_number": "183-872-3302"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "513 5TH AVE W",
"city": "GRAND MARAIS",
"state": "MN",
"postal_code": "556043017",
"telephone_number": "183-872-3302"
}
],
"practiceLocations": [
{
"address_1": "915 E 1st St",
"address_purpose": "LOCATION",
"city": "Duluth",
"state": "MN",
"postal_code": "558052107",
"country_code": "US",
"telephone_number": "218-249-5555",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DEARRUDA WHARTON",
"first_name": "KRISTIN",
"middle_name": "ELISABETH",
"credential": "APRN, FNP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-11-20",
"last_updated": "2024-06-13",
"certification_date": "2024-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MN",
"license": "7075",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MINNESOTA BOARD OF NURSING- APRN LICENSE",
"identifier": "7075",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INTERNATIONAL BOARD OF LACTATION CONSULTANT EXAMINERS",
"identifier": "11185596",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MINNESOTA BOARD OF NURSING- PUBLIC HEALTH NURSE",
"identifier": "16274",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MINNESOTA BOARD OF NURSING",
"identifier": "169220-0",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICAN ACADEMY OF NURSE PRACTITIONERS",
"identifier": "F09191840",
"state": null
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "him@slk.direct.slhduluth.com",
"affiliation": "N",
"address_1": "915 E 1st St",
"city": "Duluth",
"state": "MN",
"country_code": "US",
"postal_code": "558052107",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "KRISTIN",
"last_name": "DEARRUDA",
"middle_name": "ELISABETH",
"credential": "APRN, FNP-C",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Grand Marais, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2024; 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.