NPIMap

Individual provider Active NPI

Mark Wiita, APRN, CNP

  • Nurse Practitioner
  • Duluth, MN
National Provider Identifier
1457739179
Registry record updated Jan 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
3981 Issued in MN
Practice address
1001 E Superior St Ste L401
Duluth, MN 55802-2207
Phone
(218) 249-7960
Fax
(218) 249-7997
NPI assigned
May 14, 2015
Last updated
Jan 19, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2021

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 3981 MN Primary
Family Nurse Practitioner 363LF0000X R210059-7 MN

Addresses

Primary practice location

1001 E Superior St Ste L401
Duluth, MN 55802-2207

Mailing address

1001 E Superior St Ste L401
Duluth, MN 55802-2207
Phone (218) 249-7960

Other practice location 1

4212 Grand Ave
Essentia Health West Duluth Clinic
Duluth, MN 55807
Phone (218) 786-3500

Other practice location 2

1010 4th St
Two Harbors, MN 55616-1200
Phone (218) 834-7700

Other practice location 3

4212 Grand Ave
Essentia Health West Duluth Clinic
Duluth, MN 55807
Phone (218) 786-3500

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address him@slk.direct.slhduluth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150813011152 MN Practitioner - Nurse Practitioner 6406161884 Reassigns benefits to 1 organization
I20180530001248 WI Practitioner - Nurse Practitioner 6406161884 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St. Luke's Hospital of DuluthGroup PAC ID 7113834839, 409 clinicians

Practice addresses (Care Compare)

1001 E Superior St
Suite 401
Duluth, MN 55802-2229
Phone (218) 249-7960

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3981MNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke's Hospital of Duluth CurrentSince Jan 2, 2018 Accepting new patients
St. Luke's Hospital of Duluth CurrentSince Jan 2, 2018 Accepting new patients
St. Luke's Hospital of Duluth Current Accepting new patients
St. Luke's Hospital of Duluth CurrentSince May 1, 2018 Accepting new patients
St. Luke's Hospital of Duluth Current Accepting new patients
St. Luke's Hospital of Duluth Past Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

1001 E Superior St
Ste 401
Duluth, MN 55802
Phone (218) 249-7960

1001 E Superior St
Ste L401
Duluth, MN 55802
Phone (218) 249-7960

1015 E 1st St
Duluth, MN 55805
Phone (218) 249-7860

915 E 1st St
Duluth, MN 55805
Phone (218) 249-5352

1010 4th St
Two Harbors, MN 55616
Phone (218) 724-3083

109 N 28th St E
Superior, WI 54880
Phone (715) 395-3900

Interoperability endpoints

  • Direct secure messaging: mwiita237289@direct.aspirus.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 41

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 41

NPI Registry JSON

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

{
    "created_epoch": "1431561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611014400000",
    "number": "1457739179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 E SUPERIOR ST STE L401",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558022207",
            "telephone_number": "218-249-7960",
            "fax_number": "218-249-7997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 E SUPERIOR ST STE L401",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558022207",
            "telephone_number": "218-249-7960",
            "fax_number": "218-249-7997"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4212 Grand Ave",
            "address_2": "Essentia Health West Duluth Clinic",
            "address_purpose": "LOCATION",
            "city": "Duluth",
            "state": "MN",
            "postal_code": "55807",
            "country_code": "US",
            "telephone_number": "218-786-3500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1010 4th St",
            "address_purpose": "LOCATION",
            "city": "Two Harbors",
            "state": "MN",
            "postal_code": "556161200",
            "country_code": "US",
            "telephone_number": "218-834-7700",
            "fax_number": "218-834-7727",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4212 Grand Ave",
            "address_2": "Essentia Health West Duluth Clinic",
            "address_purpose": "LOCATION",
            "city": "Duluth",
            "state": "MN",
            "postal_code": "55807",
            "country_code": "US",
            "telephone_number": "218-786-3500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIITA",
        "first_name": "MARK",
        "credential": "APRN, CNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-14",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "3981",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "R210059-7",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@slk.direct.slhduluth.com",
            "affiliation": "N",
            "address_1": "1001 E Superior St Ste L401",
            "city": "Duluth",
            "state": "MN",
            "country_code": "US",
            "postal_code": "558022207",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.