Individual provider Active NPI

Rose Ann Lorentz, A-G NP

  • Gerontology Clinical Nurse Specialist
  • Wadena, MN
National Provider Identifier
1629419700
Registry record updated Jul 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Clinical Nurse SpecialistTaxonomy code 364SG0600X
License
R116137-5 Issued in MN
Practice address
415 Jefferson St N
Wadena, MN 56482-1264
Phone
(218) 631-3510
Fax
(218) 631-7507
NPI assigned
Jul 17, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Clinical Nurse Specialist 364SA2200X R116137-5 MN
Gerontology Clinical Nurse Specialist 364SG0600X R116137-5 MN Primary

Addresses

Primary practice location

415 Jefferson St N
Wadena, MN 56482-1264

Mailing address

12318 120TH St
Wadena, MN 56482-2258
Phone (218) 631-3194

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20130828000552 MN Practitioner - Nurse Practitioner 6406099118 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Astera HealthGroup PAC ID 2961395272, shared by 8 NPIs, 106 clinicians

Practice addresses (Care Compare)

4 Deerwood Ave NW
Wadena, MN 56482-1253
Phone (218) 631-1360

415 Jefferson St N
Wadena, MN 56482-1264
Phone (218) 631-7495

415 Jefferson St N
Wadena, MN 56482-1296

Hospital & facility affiliations

  • Astera Health Hospital, Wadena, MN, CCN 241354

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R116137-5MNMDGerontology Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Astera Health Current Accepting new patients
Astera Health CurrentSince Sep 15, 2013 Accepting new patients
Astera Health CurrentSince Sep 15, 2013 Accepting new patients

Locations

421 11th St NW
Wadena, MN 56482
Phone (218) 631-3510

415 Jefferson St N
Wadena, MN 56482
Phone (218) 631-3510

4 Deerwood Ave NW
Wadena, MN 56482
Phone (218) 631-1100

Interoperability endpoints

  • Direct secure messaging: rlorentz137841@direct.centracare.com

Organizations & group practices 3

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 2

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": "1374019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374019200000",
    "number": "1629419700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12318 120TH ST",
            "city": "WADENA",
            "state": "MN",
            "postal_code": "564822258",
            "telephone_number": "218-631-3194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 JEFFERSON ST N",
            "city": "WADENA",
            "state": "MN",
            "postal_code": "564821264",
            "telephone_number": "218-631-3510",
            "fax_number": "218-631-7507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LORENTZ",
        "first_name": "ROSE",
        "middle_name": "ANN",
        "credential": "A-G NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-17",
        "last_updated": "2013-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "MN",
            "license": "R116137-5",
            "primary": false
        },
        {
            "code": "364SG0600X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Gerontology",
            "state": "MN",
            "license": "R116137-5",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wadena, MN

Sources for this page

Verify at the official NPI Registry.