Amanda Kate Enestvedt, RN CPNP-PC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

CNP 4775 Issued in MN

Practice address

1521 Carlson St
Marshall, MN 56258

Phone

(507) 532-1101

Fax

(507) 532-1137

NPI assigned

Sep 8, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Amanda Kate Kohls Former name

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

Credentials

Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: amanda.enestvedt@avera.sdhealthlink.net

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.

• Avera Granite Falls

  • Critical Access Hospital
  • Granite Falls, MN
  • NPI 1700429610

  MN

  Medicare reassignment NPD
• Avera Granite Falls

  • Family Medicine Physician
  • Granite Falls, MN
  • NPI 1700429644

  MN

  Medicare reassignment NPD
• Avera Marshall

  • Critical Access Hospital
  • Marshall, MN
  • NPI 1568401016

  MN

  Medicare reassignment NPD
• Avera Marshall

  • Optometrist
  • Marshall, MN
  • NPI 1487422465
  NPD
• Avera Marshall

  • Durable Medical Equipment & Medical Supplies
  • Marshall, MN
  • NPI 1669622031
  NPD
• Avera Marshall

  • Multi-Specialty Clinic/Center
  • Marshall, MN
  • NPI 1962641936
  NPD (past)
• Granite Falls Municipal Hospital and Manor

  • Critical Access Hospital
  • Granite Falls, MN
  • NPI 1780654962
  NPD (past)
• Rural Health Care, Inc.

  • Federally Qualified Health Center (FQHC)
  • Murdo, SD
  • NPI 1720076441
  NPD (past)

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

{
    "created_epoch": "1473292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554163200000",
    "number": "1609323484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1521 CARLSON ST",
            "city": "MARSHALL",
            "state": "MN",
            "postal_code": "562582626",
            "telephone_number": "507-532-1101",
            "fax_number": "507-532-1137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1521 CARLSON ST",
            "city": "MARSHALL",
            "state": "MN",
            "postal_code": "56258",
            "telephone_number": "507-532-1101",
            "fax_number": "507-532-1137"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "610 30th Ave W",
            "address_purpose": "LOCATION",
            "city": "Alexandria",
            "state": "MN",
            "postal_code": "563083426",
            "country_code": "US",
            "telephone_number": "320-763-2540",
            "fax_number": "320-763-5749",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ENESTVEDT",
        "first_name": "AMANDA",
        "middle_name": "KATE",
        "credential": "RN CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-08",
        "last_updated": "2019-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MN",
            "license": "CNP 4775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "KOHLS",
            "middle_name": "KATE",
            "credential": "RN CPNP-PC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Christopher Eichten, DC
• Neil Thomas Eichten, SLP
• Connie Sue Einck, LPN
• Sandra Jo Ellingboe
• Elysian Chiropractic Center
• Brooke Lynae Engbarth, DT, RDH
• Patty Erickson, ATR
• Rebecca Ann Erickson, CNP
• Valerie Facile, RN, APRN, CNP
• Nicole Elizabeth Falls, M.D.

• All providers in Marshall, MN
• Pediatric Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2019; 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.