Roxanne Desjarlait

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

CNP 4813 Issued in MN

Practice address

General Delivery
Redlake, MN 56671-9999

Phone

(218) 679-3860

NPI assigned

Oct 6, 2016

Sex

Female

Sole proprietor

Yes

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 TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Department of Health & Human Services PHS IHS

  • Critical Access Hospital
  • Cass Lake, MN
  • NPI 1194754382

  TX

  Medicare reassignment NPD

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

{
    "created_epoch": "1475712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475712000000",
    "number": "1366992000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "GENERAL DELIVERY",
            "city": "REDLAKE",
            "state": "MN",
            "postal_code": "566719999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "GENERAL DELIVERY",
            "city": "REDLAKE",
            "state": "MN",
            "postal_code": "566719999",
            "telephone_number": "218-679-3860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESJARLAIT",
        "first_name": "ROXANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-06",
        "last_updated": "2016-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "CNP 4813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Virginia Bautista, DDS,MDS
• Autumn Leigh Beaulieu
• Jill Maria Breyen, RD,LD
• Lee Carriker, RDH
• John D Dick, MSW
• Brittany Kristene Hanrahan, LICSW
• Independent School District #38
• Susan Lucy Ninham
• Connie Jean Norman, CHW

• All providers in Redlake, MN
• Family Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.