Individual provider Active NPI

Michelle L Carl, APRN,CNP

  • Family Nurse Practitioner
  • Hermantown, MN
National Provider Identifier
1316589591
Registry record updated Oct 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CNP6851 Issued in MN
Practice address
4855 W Arrowhead Rd
Hermantown, MN 55811-3936
Phone
(218) 786-3540
NPI assigned
Oct 9, 2019
Last updated
Oct 9, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2019

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 CNP6851 MN Primary

Addresses

Primary practice location

4855 W Arrowhead Rd
Hermantown, MN 55811-3936

Mailing address

1702 University Dr S
Fargo, ND 58103-4940

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, ND2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20191031001150 MN Practitioner - Nurse Practitioner 2365774940 Reassigns benefits to 3 organizations
I20240229002890 ND Practitioner - Nurse Practitioner 2365774940 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Innovis Health LLCGroup PAC ID 9931298155, 561 clinicians
The Duluth Clinic LTDGroup PAC ID 2567374283, 1,135 clinicians

Practice addresses (Care Compare)

4110 51St Ave S
Fargo, ND 58104-7776
Phone (701) 364-3100

4855 W Arrowhead Rd
Hermantown, MN 55811-3936
Phone (218) 786-3540

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
CNP6851MNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Mary's Medical Center CurrentSince Mar 1, 2020 Accepting new patients
Innovis Health LLC CurrentSince Apr 10, 2023 Accepting new patients
Innovis Health, LLC CurrentSince Apr 10, 2023 Accepting new patients
The Duluth Clinic, LTD Current Accepting new patients
The Duluth Clinic, LTD. CurrentSince Nov 11, 2019 Accepting new patients
St Marys Medical Center Current Accepting new patients
Innovis Health LLC Current Accepting new patients
St. Mary's Medical Center CurrentSince Mar 1, 2020 Accepting new patients
Innovis Health, LLC CurrentSince Dec 31, 2023 Accepting new patients
The Duluth Clinic LTD CurrentSince Nov 11, 2019 Accepting new patients
The Duluth Clinic LTD Current Accepting new patients

Locations

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

402 E 2nd St
Duluth, MN 55805
Phone (218) 786-3443

4855 W Arrowhead Rd
Hermantown, MN 55811
Phone (218) 786-3540

208 Oppegard Ave NW
Twin Valley, MN 56584
Phone (218) 584-5181

1702 University Dr S
Fargo, ND 58103
Phone (701) 364-4222

3000 32nd Ave S
Fargo, ND 58103
Phone (701) 364-4222

4110 51st Ave S
Fargo, ND 58104
Phone (701) 364-3100

Organizations & group practices 11

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1570579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570579200000",
    "number": "1316589591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1702 UNIVERSITY DR S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581034940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4855 W ARROWHEAD RD",
            "city": "HERMANTOWN",
            "state": "MN",
            "postal_code": "558113936",
            "telephone_number": "218-786-3540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARL",
        "first_name": "MICHELLE",
        "middle_name": "L",
        "credential": "APRN,CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-09",
        "last_updated": "2019-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "CNP6851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hermantown, MN

Sources for this page

Verify at the official NPI Registry.