Individual provider Active NPI

Kristen Trosen

  • Family Nurse Practitioner
  • Moorhead, MN
National Provider Identifier
1508217183
Registry record updated Jun 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R36432 Issued in ND
Practice address
801 Belsly Boulevard
Moorhead, MN 56560
Phone
(218) 364-6800
NPI assigned
Jun 25, 2016
Last updated
Jun 9, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2022

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 R36432 ND Primary

Addresses

Primary practice location

801 Belsly Boulevard
Moorhead, MN 56560

Mailing address

1702 University Dr S
Fargo, ND 58103-4940
Phone (701) 364-4999

Other practice location 1

4622 40th Ave S
Fargo, ND 58104-4394
Phone (701) 367-2909

Other names 1

  • Kristen Johnson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, ND2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160920002427 MN Practitioner - Nurse Practitioner 7719274604 Reassigns benefits to 1 organization
I20161018003033 ND Practitioner - Nurse Practitioner 7719274604 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Innovis Health LLCGroup PAC ID 9931298155, shared by 7 NPIs, 561 clinicians

Practice addresses (Care Compare)

4476 31St Ave S
Suite 101
Fargo, ND 58104-4532
Phone (701) 234-9400

720 Main Ave
Moorhead, MN 56560-2752
Phone (218) 359-0399

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Innovis Health, LLC. CurrentSince Jan 12, 2020 Accepting new patients
Innovis Health, LLC Current Accepting new patients
Innovis Health LLC CurrentSince Mar 1, 2017 Accepting new patients
Innovis Health LLC Current Accepting new patients

Locations

400 E 3rd St
#6
Duluth, MN 55805
Phone (320) 360-1676

720 Main Ave
Moorhead, MN 56560
Phone (218) 359-0399

801 Belsly Blvd
Moorhead, MN 56560
Phone (218) 364-6800

1100 19th Ave N
Ste L
Fargo, ND 58102
Phone (701) 356-1150

1702 University Dr S
Fargo, ND 58103
Phone (701) 364-4222

3000 32nd Ave S
Fargo, ND 58103
Phone (701) 364-3000

4110 51st Ave S
Fargo, ND 58104
Phone (701) 364-3100

4476 31st Ave S
#101
Fargo, ND 58104
Phone (701) 234-9400

4622 40th Ave S
Fargo, ND 58104
Phone (701) 232-6211

4622 40th Ave S
#7
Fargo, ND 58104
Phone (701) 364-2909

Organizations & group practices 4

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 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": "1466812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654732800000",
    "number": "1508217183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1702 UNIVERSITY DR S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581034940",
            "telephone_number": "701-364-4999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 BELSLY BOULEVARD",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "56560",
            "telephone_number": "218-364-6800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4622 40th Ave S",
            "address_purpose": "LOCATION",
            "city": "Fargo",
            "state": "ND",
            "postal_code": "581044394",
            "country_code": "US",
            "telephone_number": "701-367-2909",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TROSEN",
        "first_name": "KRISTEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-25",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ND",
            "license": "R36432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "JOHNSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Moorhead, MN

Sources for this page

Verify at the official NPI Registry.