Individual provider Active NPI

Alison Vetter, NP

  • Gerontology Nurse Practitioner
  • Mandan, ND
National Provider Identifier
1306513767
Registry record updated Jul 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
R39320 Issued in ND
Practice address
910 18TH St NW
Mandan, ND 58554-1612
Phone
(701) 667-5100
NPI assigned
Aug 24, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X R39320 ND Primary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X R39320 ND

Addresses

Primary practice location

910 18TH St NW
Mandan, ND 58554-1612

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074
Phone (605) 328-9419

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
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
I20230807002180 ND Practitioner - Nurse Practitioner 3072974005 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R39320NDMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Bismarck CurrentSince Jun 27, 2023 Accepting new patients
Sanford Bismarck CurrentSince Jun 27, 2023 Accepting new patients

Locations

3318 N 14th St
Bismarck, ND 58503
Phone (701) 323-8300

910 18th St NW
Mandan, ND 58554
Phone (701) 323-8400

Organizations & group practices 2

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": "1629763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1306513767",
    "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": "605-328-9419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 18TH ST NW",
            "city": "MANDAN",
            "state": "ND",
            "postal_code": "585541612",
            "telephone_number": "701-667-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VETTER",
        "first_name": "ALISON",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-24",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "ND",
            "license": "R39320",
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "ND",
            "license": "R39320",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mandan, ND

Sources for this page

Verify at the official NPI Registry.