NPIMap

Individual provider Active NPI

Nora Bennett

  • Nurse Practitioner
  • Saint Paul, MN
National Provider Identifier
1467413526
Registry record updated Feb 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
104962-0 Issued in MN
Practice address
153 Cesar Chavez St
Saint Paul, MN 55107-2226
Phone
(651) 222-1816
Fax
(651) 602-7517
NPI assigned
Mar 29, 2006
Last updated
Feb 24, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 104962-0 MN Primary

Addresses

Primary practice location

153 Cesar Chavez St
Saint Paul, MN 55107-2226

Mailing address

174 Carlson LN
River Falls, WI 54022-8102

Other identifiers 6

IdentifierTypeStateIssuer
0105294OtherMNMEDICA
923911025969OtherMNPREFERRED ONE
29D61BEOtherMNBCBS
150768OtherMNUCARE
230662000MedicaidMN
HP31361OtherMNHEALTH PARTNERS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080104000097 WI Practitioner - Nurse Practitioner 0345254678 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Minnesota Homeopathic Medicine - NLG, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fairview ClinicsGroup PAC ID 7113830142, 799 clinicians

Practice addresses (Care Compare)

319 S Main St
River Falls, WI 54022-2452
Phone (715) 425-6701

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
104962-0MNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Western Wisconsin Medical Associates CurrentSince Dec 17, 2007 Accepting new patients
Fairview Clinics CurrentSince Oct 10, 2020 Accepting new patients

Locations

144 S Plum St
Ellsworth, WI 54011
Phone (715) 273-5041

1687 E Division St
River Falls, WI 54022
Phone (715) 425-6701

319 S Main St
River Falls, WI 54022
Phone (715) 425-6701

Interoperability endpoints

  • Direct secure messaging: nbennett491056@fairview.direct-ci.com

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 10

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": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266969600000",
    "number": "1467413526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "174 CARLSON LN",
            "city": "RIVER FALLS",
            "state": "WI",
            "postal_code": "540228102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "153 CESAR CHAVEZ ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551072226",
            "telephone_number": "651-222-1816",
            "fax_number": "651-602-7517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "NORA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-29",
        "last_updated": "2010-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "104962-0",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "0105294",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "923911025969",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "29D61BE",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "150768",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "230662000",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "HP31361",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.