Individual provider Active NPI

Saunda St Martin, NP, APRN

  • Psychiatric/Mental Health Clinical Nurse Specialist
  • Red Lake, MN
National Provider Identifier
1407866510
Registry record updated Aug 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0808X
License
R107748-5 Issued in MN
Practice address
24760 Hospital Drive
Redlake, MN 56671
Phone
(218) 679-3912
NPI assigned
Aug 9, 2006
Last updated
Aug 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Nurse Specialist 364S00000X R1077485 MN
Psychiatric/Mental Health Clinical Nurse Specialist 364SP0808X R107748-5 MN Primary

Addresses

Primary practice location

24760 Hospital Drive
Redlake, MN 56671

Mailing address

PO Box 155
Bemidji, MN 56619-0155
Phone (218) 209-1137

Other practice location 1

611 Spruce Grove Ln NW
Bemidji, MN 56601-7746
Phone (218) 209-1137

Other identifiers 6

IdentifierTypeStateIssuer
014080500MedicaidMN
0199999OtherMNMEDICA
13481MedicaidND
78M12STOtherMNBCBS
107121OtherMNHEALTH PARTNERS
P00184098OtherMNRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1503MNMDMarriage & Family Therapist
R1077485MNMDClinical Nurse Specialist
R107748-5MNMDPsychiatric/Mental Health Clinical Nurse Specialist

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534464000000",
    "number": "1407866510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 155",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566190155",
            "telephone_number": "218-209-1137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24760 HOSPITAL DRIVE",
            "city": "REDLAKE",
            "state": "MN",
            "postal_code": "56671",
            "telephone_number": "218-679-3912"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "611 Spruce Grove Ln NW",
            "address_purpose": "LOCATION",
            "city": "Bemidji",
            "state": "MN",
            "postal_code": "566017746",
            "country_code": "US",
            "telephone_number": "218-209-1137",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ST MARTIN",
        "first_name": "SAUNDA",
        "credential": "NP, APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-09",
        "last_updated": "2018-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "MN",
            "license": "R1077485",
            "primary": false
        },
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "MN",
            "license": "R107748-5",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "014080500",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "0199999",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "13481",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "78M12ST",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "107121",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00184098",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Red Lake, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.