Individual provider Active NPI

Megan Nicole Kipp

  • Physician Assistant
  • Grand Forks, ND
National Provider Identifier
1548654585
Registry record updated Nov 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA1613 Issued in NV
Practice address
4440 S Washington St
Grand Forks, ND 58201-7245
Phone
(701) 732-7000
Fax
(701) 732-7696
NPI assigned
Mar 27, 2015
Last updated
Nov 10, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA1613 NV Primary

Addresses

Primary practice location

4440 S Washington St
Grand Forks, ND 58201-7245

Mailing address

1200 S Columbia Rd
Grand Forks, ND 58201-4036
Phone (701) 780-6000

Other names 1

  • Megan Nicole King Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mkipp83818@direct.directaltru.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND, MN2 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
I20171101001149 ND Practitioner - Physician Assistant 9739409806 Reassigns benefits to 1 organization
I20210623001071 MN Practitioner - Physician Assistant 9739409806 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Altru Health SystemGroup PAC ID 1355251604, 675 clinicians

Practice addresses (Care Compare)

1380 S Columbia Rd
Grand Forks, ND 58201-4059
Phone (701) 795-2000

4440 S Washington St
Grand Forks, ND 58201-7245
Phone (701) 780-5000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
12418MNMDClinical Social Worker
PA1613NVMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Altru Health System CurrentSince Feb 5, 2018 Accepting new patients
Altru Health System CurrentSince Feb 5, 2018 Accepting new patients
Altru Health System CurrentSince May 1, 2021 Accepting new patients
Community Health Service Inc. Past Accepting new patients
Altru Health System Past Accepting new patients

Locations

400 S Minnesota St
Crookston, MN 56716
Phone (218) 281-9100

164 W 13th St
Grafton, ND 58237
Phone (701) 352-1620

1200 S Columbia Rd
Grand Forks, ND 58201
Phone (701) 780-5243

1380 S Columbia Rd
Grand Forks, ND 58201
Phone (701) 795-2000

2401 Demers Ave
Grand Forks, ND 58201
Phone (701) 780-1891

4440 S Washington St
Grand Forks, ND 58201
Phone (701) 732-7000

4440 S Washington St
Fl 1
Grand Forks, ND 58201

901 2nd St
Langdon, ND 58249
Phone (701) 256-6100

301 5th St
Walhalla, ND 58282
Phone (701) 549-2711

Interoperability endpoints

  • Direct secure messaging: mkipp83818@direct.directaltru.org

Organizations & group practices 6

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": "1427414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604966400000",
    "number": "1548654585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 S COLUMBIA RD",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582014036",
            "telephone_number": "701-780-6000",
            "fax_number": "701-780-5772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4440 S WASHINGTON ST",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582017245",
            "telephone_number": "701-732-7000",
            "fax_number": "701-732-7696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIPP",
        "first_name": "MEGAN",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-27",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA1613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mkipp83818@direct.directaltru.org",
            "affiliation": "N",
            "endpointDescription": "Direct mail",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4440 S Washington St",
            "city": "Grand Forks",
            "state": "ND",
            "country_code": "US",
            "postal_code": "582017245",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MEGAN",
            "last_name": "KING",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Grand Forks, ND

Sources for this page

Verify at the official NPI Registry.