NPIMap

Individual provider Active NPI

Ryan K Hursh, APRN, CNP

  • Nurse Practitioner
  • Cloquet, MN
National Provider Identifier
1558042622
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
10355 Issued in MN
Practice address
417 Skyline Blvd
Cloquet, MN 55720-1164
Phone
(218) 879-1271
Fax
(218) 879-8904
NPI assigned
Jul 31, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 10355 MN
Nurse Practitioner 363L00000X 10355 MN Primary

Addresses

Primary practice location

417 Skyline Blvd
Cloquet, MN 55720-1164

Mailing address

512 Skyline Blvd
Cloquet, MN 55720-3787
Phone (218) 879-1271

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ryan.hursh@rcll.eclinicaldirectplus.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231010003624 MN Practitioner - Nurse Practitioner 7618322751 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Memorial Hospital AssociationGroup PAC ID 0042129991, 47 clinicians

Practice addresses (Care Compare)

417 Skyline Blvd
Cloquet, MN 55720-1164
Phone (218) 879-1271

Hospital & facility affiliations

  • Centerwell Home Health Home health agency, Duluth, MN, CCN 247241
  • Aspirus St. Luke'S at Home - Home Care - Duluth Home health agency, Duluth, MN, CCN 247098
  • Community Memorial Hospital Hospital, Cloquet, MN, CCN 241364
  • St Lukes Hospital Hospital, Duluth, MN, CCN 240047

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Community Memorial Hospital Association CurrentSince Jan 1, 2024 Accepting new patients

Locations

417 Skyline Blvd
Cloquet, MN 55720
Phone (218) 879-1271

512 Skyline Blvd
Cloquet, MN 55720
Phone (218) 878-7207

Interoperability endpoints

  • Direct secure messaging: ryan.hursh@rcll.eclinicaldirectplus.com

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.

Hospital & facility affiliations 29

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

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1690761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1558042622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 SKYLINE BLVD",
            "city": "CLOQUET",
            "state": "MN",
            "postal_code": "557203787",
            "telephone_number": "218-879-1271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 SKYLINE BLVD",
            "city": "CLOQUET",
            "state": "MN",
            "postal_code": "557201164",
            "telephone_number": "218-879-1271",
            "fax_number": "218-879-8904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HURSH",
        "first_name": "RYAN",
        "middle_name": "K",
        "credential": "APRN, CNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-31",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "10355",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "10355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ryan.hursh@rcll.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "417 Skyline Blvd",
            "city": "Cloquet",
            "state": "MN",
            "country_code": "US",
            "postal_code": "557201164",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cloquet, MN

Sources for this page

Verify at the official NPI Registry.