Individual provider Active NPI

Kimberly Ann Schlag, APRN

  • Pediatric Nurse Practitioner
  • Bismarck, ND
National Provider Identifier
1487243507
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
R40499 Issued in ND
Practice address
222 N 7TH St
Bismarck, ND 58501-4436
Phone
(701) 323-6000
NPI assigned
Jan 13, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X R40499 ND Primary

Addresses

Primary practice location

222 N 7TH St
Bismarck, ND 58501-4436

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074

Other practice location 1

300 N 7th St
Bismarck, ND 58501-4439
Phone (701) 323-6698

Other names 1

  • Kimberly Ann Pazdernik Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20210414002864 ND Practitioner - Nurse Practitioner 6103234067 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R40499NDMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Bismarck CurrentSince Mar 22, 2021 Accepting new patients

Locations

414 N 7th St
Bismarck, ND 58501
Phone (701) 323-5870

300 N 7th St
Bismarck, ND 58501
Phone (701) 323-6153

222 N 7th St
Bismarck, ND 58501
Phone (701) 323-5422

3318 N 14th St
Bismarck, ND 58503
Phone (701) 323-8300

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.

NPI Registry JSON

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

{
    "created_epoch": "1610496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1487243507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 N 7TH ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585014436",
            "telephone_number": "701-323-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 N 7th St",
            "address_purpose": "LOCATION",
            "city": "Bismarck",
            "state": "ND",
            "postal_code": "585014439",
            "country_code": "US",
            "telephone_number": "701-323-6698",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHLAG",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-13",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "ND",
            "license": "R40499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "PAZDERNIK",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bismarck, ND

Sources for this page

Verify at the official NPI Registry.