Organization Active NPI

Nurturing Wellness Pediatrics, PLLC

  • Pediatrics Physician
  • Bismarck, ND
National Provider Identifier
1619503760
Registry record updated May 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
NURTURING WELLNESS PEDIATRICS, PLLC
Practice address
1500 Interchange Ave Ste 200
Bismarck, ND 58501-2084
Phone
(401) 952-0293
NPI assigned
Mar 20, 2020
Last updated
May 5, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2020

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

Authorized official

Name
Dr. Kathy Melissa Anderson, MDNPI 1942405923
Title
Pediatrician
Phone
(401) 952-0293

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X NU Primary

Addresses

Primary practice location

1500 Interchange Ave Ste 200
Bismarck, ND 58501-2084

Mailing address

5119 Fountainblue Dr
Bismarck, ND 58503-8893
Phone (401) 952-0293

Other practice location 1

5119 Fountainblue Dr
Bismarck, ND 58503-8893
Phone (401) 952-0293

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230731001311 ND Part B Supplier - Clinic/Group Practice 3072974617 Receives reassigned benefits from 1 practitioner
Practice locations: Bismarck, ND

National Provider Directory

National Provider Directory

Locations

1500 Interchange Ave
Ste 200
Bismarck, ND 58501
Phone (401) 952-0293

1930 Burnt Boat Dr
#B
Bismarck, ND 58503
Phone (701) 400-9596

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/26013/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1584662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588636800000",
    "number": "1619503760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5119 FOUNTAINBLUE DR",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585038893",
            "telephone_number": "401-952-0293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 INTERCHANGE AVE STE 200",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585012084",
            "telephone_number": "401-952-0293"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5119 Fountainblue Dr",
            "address_purpose": "LOCATION",
            "city": "Bismarck",
            "state": "ND",
            "postal_code": "585038893",
            "country_code": "US",
            "telephone_number": "401-952-0293",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NURTURING WELLNESS PEDIATRICS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-20",
        "last_updated": "2020-05-05",
        "certification_date": "2020-05-05",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "KATHY",
        "authorized_official_middle_name": "MELISSA",
        "authorized_official_title_or_position": "PEDIATRICIAN",
        "authorized_official_telephone_number": "401-952-0293",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bismarck, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.