Individual provider Active NPI

Destiny Brianne Amundson, APRN, CNP

  • Nurse Practitioner
  • Crosby, MN
National Provider Identifier
1326765892
Registry record updated May 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
9651 Issued in MN
Practice address
320 East Main St
Crosby, MN 56441
Phone
(218) 546-7000
Fax
(218) 546-4400
NPI assigned
Oct 25, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 9651 MN
Nurse Practitioner 363L00000X 9651 MN Primary

Addresses

Primary practice location

320 East Main St
Crosby, MN 56441

Mailing address

320 East Main St
Crosby, MN 56441
Phone (218) 546-7000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address damundson@selecturgentcare.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20230124001439 MN Practitioner - Nurse Practitioner 4284005539 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cuyuna Regional Medical CenterGroup PAC ID 9537146550, shared by 3 NPIs, 133 clinicians

Practice addresses (Care Compare)

320 E Main St
Crosby, MN 56441-1645
Phone (218) 546-7000

Hospital & facility affiliations

  • Cuyuna Regional Medical Center Hospital, Crosby, MN, CCN 241353

Merit-based Incentive Payment System (MIPS)

Final score
93.78 of 100Reported as apm
Quality
80.38
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9651MNMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Select Urgent Care LLC CurrentSince Oct 24, 2022 Accepting new patients
Cuyuna Regional Medical Center Current Accepting new patients
Cuyuna Regional Medical Center CurrentSince May 1, 2023 Accepting new patients
Cuyuna Regional Medical Center CurrentSince May 1, 2023 Accepting new patients

Locations

320 E Main St
Crosby, MN 56441
Phone (218) 546-7000

190 Central Ave S
Milaca, MN 56353
Phone (224) 487-4368

Interoperability endpoints

  • Direct secure messaging: damundson627966@excellian.direct.allina.com
  • FHIR API: https://api.platform.athenahealth.com/28265/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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": "1666656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685404800000",
    "number": "1326765892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 EAST MAIN ST",
            "city": "CROSBY",
            "state": "MN",
            "postal_code": "56441",
            "telephone_number": "218-546-7000",
            "fax_number": "218-546-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 EAST MAIN ST",
            "city": "CROSBY",
            "state": "MN",
            "postal_code": "56441",
            "telephone_number": "218-546-7000",
            "fax_number": "218-546-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMUNDSON",
        "first_name": "DESTINY",
        "middle_name": "BRIANNE",
        "name_prefix": "Mrs.",
        "credential": "APRN, CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-25",
        "last_updated": "2023-05-30",
        "certification_date": "2023-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MN",
            "license": "9651",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "9651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "damundson@selecturgentcare.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Email",
            "address_1": "190 Central Ave S",
            "city": "Milaca",
            "state": "MN",
            "country_code": "US",
            "postal_code": "563531123",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Crosby, MN

Sources for this page

Verify at the official NPI Registry.