Active NPI
Mercedez M Marvig, APRN, CNP
- Psychiatric/Mental Health Nurse Practitioner
- Fargo, ND
National Provider Identifier
1386486975
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- R46554
- Practice address
- 1702 University Dr S
Fargo, ND 58103-4940 - Phone
- (701) 364-3300
- NPI assigned
- Jun 12, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | R46554 | ND | Primary |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 12058 | MN |
Addresses
Primary practice location
1702 University Dr S
Fargo, ND 58103-4940
Mailing address
1702 University Dr S
Fargo, ND 58103-4940
Other practice location 1
1811 Weir Dr Ste 270
Woodbury, MN 55125-6741
Phone (952) 854-5034
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1811 Weir Dr
Suite 270
Woodbury, MN 55125-6741
Phone 6517149646651714
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12058 | MN | MD | Physician Assistant |
| R46554 | ND | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nystrom & Associates, LTD | Current | Accepting new patients | |
| Family Support Services Inc. | Current | Accepting new patients |
Locations
1900 Silver Lake Rd NW
Ste 110
Saint Paul, MN 55112
Phone (651) 379-1718
1811 Weir Dr
Ste 270
Woodbury, MN 55125
Phone (651) 243-6087
Organizations & group practices 2
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.
-
- Clinical Social Worker
- New Brighton, MN
- NPI 1396750188
-
- Mental Health Counselor
- New Brighton, MN
- NPI 1467549220
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1718150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1763424000000",
"number": "1386486975",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1702 UNIVERSITY DR S",
"city": "FARGO",
"state": "ND",
"postal_code": "581034940"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1702 UNIVERSITY DR S",
"city": "FARGO",
"state": "ND",
"postal_code": "581034940",
"telephone_number": "701-364-3300"
}
],
"practiceLocations": [
{
"address_1": "1811 Weir Dr Ste 270",
"address_purpose": "LOCATION",
"city": "Woodbury",
"state": "MN",
"postal_code": "551256741",
"country_code": "US",
"telephone_number": "952-854-5034",
"fax_number": "952-854-5363",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MARVIG",
"first_name": "MERCEDEZ",
"middle_name": "M",
"credential": "APRN, CNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-06-12",
"last_updated": "2025-11-18",
"certification_date": "2025-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "ND",
"license": "R46554",
"primary": true
},
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "MN",
"license": "12058",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fargo, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2025; 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.