Clint Pakkala, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

4704285427 Issued in MI

Practice address

205 Osceola St
Laurium, MI 49913-2134

Phone

(906) 337-6500

NPI assigned

Feb 19, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dickinson County Healthcare SystemGroup PAC ID 6800784943, 103 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Marshfield Medical Center Hospital, Iron Mountain, MI, CCN 231342
• Dickinson County Memorial Hospital Hospital, Iron Mountain, MI, CCN 230055
• Aspirus Iron River Hospital & Clinics, Inc Hospital, Iron River, MI, CCN 231318
• Bellin Memorial Hospital Hospital, Green Bay, WI, CCN 520049

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: clint.pakkala.1@22710.direct.athenahealth.com
• Direct secure messaging: clint.pakkala@marshfieldclinichealthsystem.cernerdirect.com

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.

• Dickinson County Healthcare System

  dba Marshfield Medical Center - Dickinson Professional Services

  • Emergency Medical Services (Emergency Medicine) Physician
  • Iron Mountain, MI
  • NPI 1891751186
  Medicare reassignment Care Compare group
• Aspirus Iron River Hospital & Clinics, Inc.

  dba Aspirus Iron River Hospital

  • Critical Access Hospital
  • Iron River, MI
  • NPI 1497750830
  Medicare reassignment NPD
• Aspirus Keweenaw

  dba Aspirus Laurium Clinic

  • Rural Health Clinic/Center
  • Laurium, MI
  • NPI 1205998713
  Medicare reassignment NPD
• Aspirus Iron River Hospital & Clinics, Inc.

  dba Aspirus Iron River Clinic

  • Rural Health Clinic/Center
  • Iron River, MI
  • NPI 1306344783
  NPD
• Aspirus Keweenaw

  dba Aspirus Ontonagon Clinic

  • Rural Health Clinic/Center
  • Ontonagon, MI
  • NPI 1023161932
  NPD
• MCHS Hospitals Inc

  dba Marshfield Medical Center

  • Clinic/Center
  • Marshfield, WI
  • NPI 1093221434
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Aspirus Iron River Hospital & Clinics, Inc.

  dba Aspirus Iron River Clinic

  • Multi-Specialty Clinic/Center
  • Iron River, MI
  • NPI 1457865198

  Hospital

  Care Compare affiliation
• Aspirus Iron River Hospital & Clinics, Inc.

  dba Aspirus Iron River Hospital

  • Critical Access Hospital
  • Iron River, MI
  • NPI 1497750830
  Care Compare affiliation
• Dickinson County Healthcare System

  dba Marshfield Medical Center - Dickinson

  • Critical Access Hospital
  • Iron Mountain, MI
  • NPI 1841188604
  Care Compare affiliation
• Bellin Memorial Hospital Inc.

  • General Acute Care Hospital
  • Green Bay, WI
  • NPI 1891740585
  Care Compare affiliation

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

{
    "created_epoch": "1518998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518998400000",
    "number": "1326548157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1031 ASH ST",
            "city": "HANCOCK",
            "state": "MI",
            "postal_code": "499301150",
            "telephone_number": "906-281-7190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 OSCEOLA ST",
            "city": "LAURIUM",
            "state": "MI",
            "postal_code": "499132134",
            "telephone_number": "906-337-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAKKALA",
        "first_name": "CLINT",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-19",
        "last_updated": "2018-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704285427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Lynn Macdonald, NP
• Nathan Dale McParlan, M.D.
• Robin Meneguzzo, FNP-C
• Nancy Leigh Barkell
• John R Novosad, MD
• Larisa Pavlovna Petrova-Pollard, MASSAGE THERAPIST
• Laura Polakowski
• Leah Polzien, D.C.
• Richard John Raffaelli, PA-C
• Tom David Raisanen, M.D.

• Nurse Practitioner in Laurium, MI
• Providers in Laurium, MI by specialty
• Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2018; 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.