Individual provider Active NPI

Mary Verdun, DNP, FNP-BC

  • Nurse Practitioner
  • Rochester, MN
National Provider Identifier
1417593922
Registry record updated Sep 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
7042 Issued in MN
Practice address
200 1St St SW
Rochester, MN 55905-1906
Phone
(507) 284-2511
NPI assigned
Nov 19, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 7042 MN
Nurse Practitioner 363L00000X 7042 MN Primary

Addresses

Primary practice location

200 1St St SW
Rochester, MN 55905-1906

Mailing address

200 1St St SW
Rochester, MN 55905-0001
Phone (507) 284-2511

Other identifiers 1

IdentifierTypeStateIssuer
7042OtherMNSTATE OF MN BOARD OF NURSING CERTIFIED NURSE PRACTITIONER

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mverdun947845@ehrdirect.mayoclinicmsg.org

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
I20191127001241 MN Practitioner - Nurse Practitioner 2163855495 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Health System-Southeast Minnesota Region CurrentSince Dec 2, 2019 Accepting new patients
Mayo Clinic CurrentSince Sep 29, 2021 Accepting new patients
Mayo Clinic Health System-Lake City CurrentSince Dec 2, 2019 Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region Current Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region CurrentSince Dec 2, 2019 Accepting new patients
Mayo Clinic CurrentSince Sep 29, 2021 Accepting new patients

Locations

404 W Fountain St
Albert Lea, MN 56007
Phone (507) 377-6285

500 W Grant St
Lake City, MN 55041
Phone (651) 345-3321

701 Hewitt Blvd
Red Wing, MN 55066
Phone (507) 377-6285

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

Interoperability endpoints

  • Direct secure messaging: mverdun947845@ehrdirect.mayoclinicmsg.org

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1574121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632096000000",
    "number": "1417593922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "507-284-2511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559051906",
            "telephone_number": "507-284-2511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERDUN",
        "first_name": "MARY",
        "credential": "DNP, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-19",
        "last_updated": "2021-09-20",
        "certification_date": "2021-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "7042",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "7042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF MN BOARD OF NURSING CERTIFIED NURSE PRACTITIONER",
            "identifier": "7042",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mverdun947845@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "200 1st St SW",
            "city": "Rochester",
            "state": "MN",
            "country_code": "US",
            "postal_code": "559051906",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rochester, MN

Sources for this page

Verify at the official NPI Registry.