NPIMap

Individual provider Active NPI

Janessa Lynne Hegstrom, FNP-C

  • Nurse Practitioner
  • Grand Forks, ND
National Provider Identifier
1356945794
Registry record updated Apr 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R30524 Issued in ND
Practice address
1300 S Columbia Rd
Grand Forks, ND 58201-4012
Phone
(701) 780-2300
NPI assigned
Nov 25, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X R30524 ND
Nurse Practitioner 363L00000X R30524 ND Primary

Addresses

Primary practice location

1300 S Columbia Rd
Grand Forks, ND 58201-4012

Mailing address

2401 Demers Ave
Grand Forks, ND 58201
Phone (701) 741-9967

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND, MN2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210105003092 ND Practitioner - Nurse Practitioner 4880007186 Reassigns benefits to 1 organization
I20210512000162 MN Practitioner - Nurse Practitioner 4880007186 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Altru Health SystemGroup PAC ID 1355251604, 675 clinicians

Practice addresses (Care Compare)

1001 7TH St NE
Devils Lake, ND 58301-2719
Phone (701) 662-2157

1200 S Columbia Rd
Grand Forks, ND 58201-4036
Phone (701) 780-5000

1300 S Columbia Rd
Grand Forks, ND 58201-4012
Phone (701) 780-5000

1380 S Columbia Rd
Grand Forks, ND 58201-4059
Phone (701) 795-2000

711 Delmore Dr
Roseau, MN 56751-1534
Phone (218) 463-1365

715 Delmore Dr
Roseau, MN 56751-1534
Phone (218) 463-2500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R30524NDMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Altru Health System CurrentSince Jan 17, 2021 Accepting new patients
Altru Health System Surgery Current Accepting new patients
Altru Health System CurrentSince Jan 17, 2021 Accepting new patients
Altru Health System Current Accepting new patients
Altru Health System CurrentSince Apr 1, 2021 Accepting new patients

Locations

711 Delmore Dr
Roseau, MN 56751
Phone (218) 463-1365

1001 7th St NE
Devils Lake, ND 58301
Phone (701) 662-2157

1380 S Columbia Rd
Grand Forks, ND 58201
Phone (701) 795-2000

1300 S Columbia Rd
Grand Forks, ND 58201
Phone (701) 780-2300

2401 Demers Ave
Grand Forks, ND 58201
Phone (701) 780-1891

Organizations & group practices 5

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 12

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": "1606262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650326400000",
    "number": "1356945794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 DEMERS AVE",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "58201",
            "telephone_number": "701-741-9967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 S COLUMBIA RD",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582014012",
            "telephone_number": "701-780-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEGSTROM",
        "first_name": "JANESSA",
        "middle_name": "LYNNE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-25",
        "last_updated": "2022-04-19",
        "certification_date": "2022-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "ND",
            "license": "R30524",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ND",
            "license": "R30524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Forks, ND

Sources for this page

Verify at the official NPI Registry.