Individual provider Active NPI

Nicole M Whiting, CNP

  • Family Nurse Practitioner
  • Alexandria, MN
National Provider Identifier
1467757476
Registry record updated Dec 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R164197-6 Issued in MN
Practice address
519 22ND Ave E
Alexandria, MN 56308-4652
Phone
(320) 219-7611
Fax
(320) 219-7612
NPI assigned
Jan 22, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R164197-6 MN Primary

Addresses

Primary practice location

519 22ND Ave E
Alexandria, MN 56308-4652

Mailing address

166 19TH St S
Ste 101
Sartell, MN 56377-2154
Phone (320) 230-7788

Other names 1

  • Nicole M Marti Former name

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
I20111213000925 MN Practitioner - Nurse Practitioner 8628243003 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Center for Pain Management, P.a.Group PAC ID 8820008832, 15 clinicians

Practice addresses (Care Compare)

804 23Rd St S
Sartell, MN 56377-4705
Phone (320) 230-7788

Hospital & facility affiliations

  • Alomere Health Hospital, Alexandria, MN, CCN 240030

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1475MNMDMarriage & Family Therapist
R164197-6MNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Pain Management, P.a. CurrentSince Feb 1, 2016 Accepting new patients

Locations

519 22nd Ave E
Alexandria, MN 56308
Phone (320) 219-7611

15620 Edgewood Dr
Ste 200
Brainerd, MN 56401
Phone (218) 270-3111

166 19th St S
Ste 101
Sartell, MN 56377
Phone (320) 230-7788

804 23rd St S
Sartell, MN 56377
Phone (320) 230-7788

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1295654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577059200000",
    "number": "1467757476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "166 19TH ST S",
            "address_2": "STE 101",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "563772154",
            "telephone_number": "320-230-7788",
            "fax_number": "320-230-7789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "519 22ND AVE E",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563084652",
            "telephone_number": "320-219-7611",
            "fax_number": "320-219-7612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITING",
        "first_name": "NICOLE",
        "middle_name": "M",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-22",
        "last_updated": "2019-12-23",
        "certification_date": "2019-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "R164197-6",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "MARTI",
            "middle_name": "M",
            "credential": "CNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Alexandria, MN

Sources for this page

Verify at the official NPI Registry.