Individual provider Active NPI

Jaycee Kuntz

  • Primary Care Nurse Practitioner
  • Fargo, ND
National Provider Identifier
1508687914
Registry record updated Aug 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
TEMP200954 Issued in ND
Practice address
3274 51St St S
Fargo, ND 58104-7179
Phone
(701) 740-4876
NPI assigned
Oct 18, 2024
Last updated
Aug 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X TEMP200954 ND Primary

Addresses

Primary practice location

3274 51St St S
Fargo, ND 58104-7179

Mailing address

3654 56TH St S
Fargo, ND 58104-4492

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
I20250618000770 ND Practitioner - Nurse Practitioner 3577074327 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stellar Healthcare, LTDGroup PAC ID 6406031129, 3 clinicians

Practice addresses (Care Compare)

3274 51St St S
Fargo, ND 58104-7179
Phone (701) 364-3660

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TEMP200954NDMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Stellar Healthcare, LTD CurrentSince Jun 5, 2025 Accepting new patients

Locations

3274 51st St S
Fargo, ND 58104
Phone (701) 364-3660

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1729209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754870400000",
    "number": "1508687914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3654 56TH ST S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581044492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3274 51ST ST S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581047179",
            "telephone_number": "701-740-4876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUNTZ",
        "first_name": "JAYCEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-18",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "ND",
            "license": "TEMP200954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.