NPIMap

Individual provider Active NPI

Tasha Waage, CNP

  • Family Nurse Practitioner
  • Deer River, MN
National Provider Identifier
1306250402
Registry record updated Jun 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R205269-0 Issued in MN
Practice address
115 10TH Ave NE Ste a
Deer River, MN 56636-8795
Phone
(218) 246-8275
NPI assigned
Jun 17, 2014
Last updated
Jun 17, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R205269-0 MN Primary

Addresses

Primary practice location

115 10TH Ave NE Ste a
Deer River, MN 56636-8795

Mailing address

115 10TH Ave NE Ste a
Deer River, MN 56636-8795
Phone (218) 246-8275

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
I20141002001652 MN Practitioner - Nurse Practitioner 6103046719 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Duluth Clinic LTDGroup PAC ID 2567374283, 1,135 clinicians

Practice addresses (Care Compare)

1542 Golf Course Rd
Suite 204
Grand Rapids, MN 55744-3537
Phone (218) 999-7000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R205269-0MNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Deer River Healthcare Center, Inc. CurrentSince Sep 22, 2014 Accepting new patients
Deer River Healthcare Center, Inc. CurrentSince Sep 22, 2014 Accepting new patients
Deer River Healthcare Center, Inc. Current Accepting new patients
The Duluth Clinic, LTD. CurrentSince Apr 11, 2018 Accepting new patients
The Duluth Clinic, LTD CurrentSince Apr 11, 2018 Accepting new patients
The Duluth Clinic LTD Current Accepting new patients
Essentia Health Virginia LLC Past Accepting new patients

Locations

115 10th Ave NE
Deer River, MN 56636
Phone (218) 246-2900

115 10th Ave NE
#A
Deer River, MN 56636
Phone (218) 246-8275

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

1542 Golf Course Rd
Ste 203
Grand Rapids, MN 55744
Phone (218) 322-4900

1542 Golf Course Rd
Ste 204
Grand Rapids, MN 55744
Phone (218) 322-4900

1232 Birch St N
Tower, MN 55790
Phone (218) 753-7788

Organizations & group practices 7

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": "1402963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402963200000",
    "number": "1306250402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 10TH AVE NE STE A",
            "city": "DEER RIVER",
            "state": "MN",
            "postal_code": "566368795",
            "telephone_number": "218-246-8275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 10TH AVE NE STE A",
            "city": "DEER RIVER",
            "state": "MN",
            "postal_code": "566368795",
            "telephone_number": "218-246-8275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAAGE",
        "first_name": "TASHA",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-17",
        "last_updated": "2014-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "R205269-0",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deer River, MN

Sources for this page

Verify at the official NPI Registry.