Carmen Mittleider, APRN,CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R27769 Issued in ND

Practice address

2430 20TH St SW
Jamestown, ND 58401-6201

Phone

(701) 253-5300

Fax

(701) 253-5402

NPI assigned

Sep 23, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ND

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

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Innovis Health LLCGroup PAC ID 9931298155, 561 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Jamestown Regional Medical Center Home Health Home health agency, Jamestown, ND, CCN 357002
• Essentia Health Hospital, Fargo, ND, CCN 350070
• Jamestown Regional Medical Center Hospital, Jamestown, ND, CCN 351335

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

Practice roles

Locations

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.

• Innovis Health, LLC

  • General Acute Care Hospital
  • Fargo, ND
  • NPI 1215125463
  Medicare reassignment Care Compare group NPD
• Innovis Health LLC

  • Multi-Specialty Clinic/Center
  • Fargo, ND
  • NPI 1144776576
  NPD
• Innovis Health, LLC.

  • Family Medicine Physician
  • Lisbon, ND
  • NPI 1043490790
  NPD

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

• Innovis Health, LLC

  • General Acute Care Hospital
  • Fargo, ND
  • NPI 1215125463
  Care Compare affiliation
• Lutheran Charity Association

  • Home Health Agency
  • Jamestown, ND
  • NPI 1528052511
  Care Compare affiliation
• Lutheran Charity Association

  • Critical Access Hospital
  • Jamestown, ND
  • NPI 1548256753
  Care Compare affiliation

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

{
    "created_epoch": "1442966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451347200000",
    "number": "1487023180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6001",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581086001",
            "telephone_number": "701-253-5300",
            "fax_number": "701-253-5402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2430 20TH ST SW",
            "city": "JAMESTOWN",
            "state": "ND",
            "postal_code": "584016201",
            "telephone_number": "701-253-5300",
            "fax_number": "701-253-5402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITTLEIDER",
        "first_name": "CARMEN",
        "credential": "APRN,CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-23",
        "last_updated": "2015-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ND",
            "license": "R27769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tina Mikkelson
• Brittany Marie Mildenberger
• Adam D. Miller, PSY.D.
• Clinton S Miller, D.M.D.
• Amanda Kathleen Mindt, MS, OTR/L
• Halie Mittleider
• Julie Renee Mittleider, LPN
• Chelsea Modlin, LSCW
• Martin Dean Monek, LAC
• Cassandra Lee Monk, RN, NP

• Family Nurse Practitioner in Jamestown, ND
• Providers in Jamestown, ND by specialty
• Family Nurse Practitioner in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.