Individual provider Active NPI

Kara De Groot, ARNP

  • Nurse Practitioner
  • Willmar, MN
National Provider Identifier
1386990315
Registry record updated Dec 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
7466 Issued in MN
Practice address
1801 19TH Ave SW
Willmar, MN 56201-4946
Phone
(000) 000-0000
NPI assigned
Jul 27, 2012
Last updated
Dec 1, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 129655 IA
Nurse Practitioner 363L00000X 7466 MN Primary

Addresses

Primary practice location

1801 19TH Ave SW
Willmar, MN 56201-4946

Mailing address

1801 19TH Ave SW
Willmar, MN 56201-4946

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
I20201207001331 MN Practitioner - Nurse Practitioner 4284883307 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Janning ENT Center, LLCGroup PAC ID 5496788077, 4 clinicians

Practice addresses (Care Compare)

1801 19TH Ave SW
Willmar, MN 56201-4946
Phone (320) 231-3277

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7466MNMDPhysical Therapist
129655IAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Avera Marshall CurrentSince Jan 2, 2021 Accepting new patients
Avera Marshall CurrentSince Jan 2, 2021 Accepting new patients
Janning ENT Center, LLC CurrentSince Oct 12, 2020 Accepting new patients

Locations

300 S Bruce St
Marshall, MN 56258
Phone (507) 532-9631

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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": "1343347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606780800000",
    "number": "1386990315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 19TH AVE SW",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "562014946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 19TH AVE SW",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "562014946",
            "telephone_number": "000-000-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE GROOT",
        "first_name": "KARA",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-27",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IA",
            "license": "129655",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "7466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willmar, MN

Sources for this page

Verify at the official NPI Registry.