Melodie Anne Kabanuk Dohm, APRN-CNP, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

6419 Issued in MN

Practice address

2704 Mounds View Blvd Ste 12
Saint Paul, MN 55112-4366

Phone

(320) 232-0647

Fax

(567) 205-3614

NPI assigned

Feb 13, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Wisdom Psychiatric Care and Medication Management LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Mounds View, MN
  • NPI 1255925962

  Psychiatric/Mental Health

  NPD Authorized official
• Wisdom Psychiatric Care and Medication Management

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bentonville, AR
  • NPI 1639048051
  NPD Authorized official
• Indian Health Board of Minneapolis, Inc

  • Federally Qualified Health Center (FQHC)
  • Minneapolis, MN
  • NPI 1760949168
  NPD (past)

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

{
    "created_epoch": "1550016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762732800000",
    "number": "1578029757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2704 MOUNDS VIEW BLVD STE 12",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551124366",
            "telephone_number": "320-232-0647",
            "fax_number": "567-205-3614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2704 MOUNDS VIEW BLVD STE 12",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551124366",
            "telephone_number": "320-232-0647",
            "fax_number": "567-205-3614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KABANUK DOHM",
        "first_name": "MELODIE",
        "middle_name": "ANNE",
        "credential": "APRN-CNP, PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-13",
        "last_updated": "2025-11-10",
        "certification_date": "2025-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "6419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacob Justen
• Cathy Juve, WHCNP
• K & K Vision, Inc.
• Binod K C, MD
• Kathryn Kaari, SLP
• Kabe Therapeutic Services LLC
• Kamal Kadir Kabeto
• Aliaksandr Kachan
• Kyra Kaczmarczik
• Harira Kadir

• Psychiatric/Mental Health Nurse Practitioner in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.