NPIMap

Individual provider Active NPI

Kristine Ranae Shaffer, ARNP

  • Family Nurse Practitioner
  • Worthington, MN
National Provider Identifier
1275286551
Registry record updated Feb 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9515 Issued in MN
Practice address
1680 Diagonal Rd
Worthington, MN 56187-1008
Phone
(507) 372-3800
NPI assigned
Jan 27, 2022
Last updated
Feb 28, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X A165927 IA
Family Nurse Practitioner 363LF0000X 9515 MN Primary

Addresses

Primary practice location

1680 Diagonal Rd
Worthington, MN 56187-1008

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074
Phone (605) 328-6585

Other practice location 1

534 9th Ave
Sibley, IA 51249-1412
Phone (712) 461-2050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230313000845 MN Practitioner - Nurse Practitioner 3678947785 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanford Health NetworkGroup PAC ID 6800707100, 357 clinicians

Practice addresses (Care Compare)

1018 6TH Ave
Worthington, MN 56187-2202
Phone (507) 372-3800

1680 Diagonal Rd
Worthington, MN 56187-1008
Phone (507) 372-3800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.53 of 100Reported as group
Quality
80.98
Promoting interoperability
100
Improvement activities
40
Cost
70.78

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9515MNMDDentist
A165927IAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Health Network CurrentSince Nov 30, 2022 Accepting new patients
Sanford Health Network CurrentSince Nov 30, 2022 Accepting new patients
Sanford Health Network Current Accepting new patients
Sanford Clinic Past Accepting new patients

Locations

1018 6th Ave
Worthington, MN 56187
Phone (507) 343-6100

1680 Diagonal Rd
Worthington, MN 56187
Phone (507) 372-3800

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1643241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677542400000",
    "number": "1275286551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074",
            "telephone_number": "605-328-6585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1680 DIAGONAL RD",
            "city": "WORTHINGTON",
            "state": "MN",
            "postal_code": "561871008",
            "telephone_number": "507-372-3800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "534 9th Ave",
            "address_purpose": "LOCATION",
            "city": "Sibley",
            "state": "IA",
            "postal_code": "512491412",
            "country_code": "US",
            "telephone_number": "712-461-2050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAFFER",
        "first_name": "KRISTINE",
        "middle_name": "RANAE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-27",
        "last_updated": "2023-02-28",
        "certification_date": "2023-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A165927",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "9515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worthington, MN

Sources for this page

Verify at the official NPI Registry.