Individual provider Active NPI

Mary J McCarthy, APRN, CNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Park Rapids, MN
National Provider Identifier
1396469946
Registry record updated Sep 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
9714 Issued in MN
Practice address
705 Pleasant Ave S
Park Rapids, MN 56470-1440
Phone
(218) 732-2800
NPI assigned
Sep 28, 2022
Last updated
Sep 22, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 9714 MN Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 201648 ND
Registered Nurse 163W00000X 2465720 MN

Addresses

Primary practice location

705 Pleasant Ave S
Park Rapids, MN 56470-1440

Mailing address

1702 University Dr S
Fargo, ND 58103-4940
Phone (701) 364-8000

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
I20221207000977 MN Practitioner - Nurse Practitioner 6800265224 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
Telehealth
Offers telehealth services
Group practices
St Marys Regional Health CenterGroup PAC ID 2062326820, shared by 12 NPIs, 190 clinicians
Sanford ClinicGroup PAC ID 0244143824, 268 clinicians

Practice addresses (Care Compare)

1001 Minnesota Ave W
Suite 101
Walker, MN 56484-2296
Phone (320) 223-0260

1027 Washington Ave
Detroit Lakes, MN 56501-3409
Phone (218) 844-2300

107 1St St E
Canby, MN 56220-1342
Phone (507) 223-7221

110 Michigan Ave W
Walker, MN 56484-2274
Phone (218) 547-6900

705 Pleasant Ave S
Park Rapids, MN 56470-1440
Phone (218) 732-2800

8990 70TH Ave NW
Walker, MN 56484-2069

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2465720MNMDRegistered Nurse
9714MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Health of Northern Minnesota CurrentSince Nov 6, 2023 Accepting new patients
Sanford Health of Northern Minnesota Current Accepting new patients
Sanford Health of Northern Minnesota CurrentSince Nov 6, 2023 Accepting new patients
Mirabilis Health Psychiatric/Mental Health CurrentSince Dec 17, 2024 Accepting new patients

Locations

1611 Anne St NW
Bemidji, MN 56601
Phone (218) 333-2020

7981 Town Hall Rd NW
Walker, MN 56484
Phone (320) 223-0260

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1664323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790035200000",
    "number": "1396469946",
    "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",
            "telephone_number": "701-364-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 PLEASANT AVE S",
            "city": "PARK RAPIDS",
            "state": "MN",
            "postal_code": "564701440",
            "telephone_number": "218-732-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCARTHY",
        "first_name": "MARY",
        "middle_name": "J",
        "credential": "APRN, CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-28",
        "last_updated": "2026-09-22",
        "certification_date": "2026-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "9714",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ND",
            "license": "201648",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "2465720",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Park Rapids, MN

Sources for this page

Verify at the official NPI Registry.