Katelynn Landis

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

417 Main Ave Ste 401
Fargo, ND 58103-1956

Phone

(701) 290-7772

NPI assigned

Dec 13, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ND

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advocates for Change 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Advocates for Change

  • Community/Behavioral Health Agency
  • Fargo, ND
  • NPI 1831965748

  Clinical, ND

  Medicare reassignment Care Compare group NPD
• Community Uplift Program

  • Family Medicine Physician
  • Fargo, ND
  • NPI 1538661384
  NPD

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

{
    "created_epoch": "1702425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702425600000",
    "number": "1316715980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 MAIN AVE STE 401",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581031956",
            "telephone_number": "701-290-7772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 MAIN AVE STE 401",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581031956",
            "telephone_number": "701-290-7772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDIS",
        "first_name": "KATELYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-13",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James H. Lancaster, DDS, MS
• Lance K Bergstrom MD, PC
• Daniel Barrett Landauer, PHD
• Nicole Landen, CRNA
• Joshua Landis, LBSW
• Kaitlin Landowski, DC
• Jennifer Landphere, B.S., LAC
• Monica Landry, DC
• Zachary Landry
• Hannah Laney

• All providers in Fargo, ND
• Clinical Social Worker in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2023; 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.

Verify at the official NPI Registry.