Individual provider Active NPI

Ethan Douglas Buehl, APRN, CNP, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Grand Forks, ND
National Provider Identifier
1669322533
Registry record updated Jul 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
13830 Issued in MN
Practice address
3674 S Washington St
Grand Forks, ND 58201-5766
Phone
(701) 205-3000
Fax
(701) 732-2501
NPI assigned
Jan 30, 2026
Last updated
Jul 9, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 13830 MN Primary

Addresses

Primary practice location

3674 S Washington St
Grand Forks, ND 58201-5766

Mailing address

PO Box 5210
Grand Forks, ND 58206-5210

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, AK, ND3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20260423000445 MN Practitioner - Nurse Practitioner 7012484439 Reassigns benefits to 1 organization
I20260603002451 AK Practitioner - Nurse Practitioner 7012484439 Reassigns benefits to 3 organizations
I20260608000750 ND Practitioner - Nurse Practitioner 7012484439 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3674 S Washington St
Grand Forks, ND 58201-5766

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13830MNMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Peterson Medical Clinics, LLC CurrentSince May 1, 2026 Accepting new patients

Locations

205 E Benson Blvd
Ste 401
Anchorage, AK 99503

519 Anne St NW
Ste A
Bemidji, MN 56601
Phone (218) 444-5700

4501 15th Ave SW
Ste 105
Fargo, ND 58103

3674 S Washington St
Grand Forks, ND 58201
Phone (701) 732-2538

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1769731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783555200000",
    "number": "1669322533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5210",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582065210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3674 S WASHINGTON ST",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582015766",
            "telephone_number": "701-205-3000",
            "fax_number": "701-732-2501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUEHL",
        "first_name": "ETHAN",
        "middle_name": "DOUGLAS",
        "name_prefix": "Mr.",
        "credential": "APRN, CNP, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-01-30",
        "last_updated": "2026-07-09",
        "certification_date": "2026-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "13830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Forks, ND

Sources for this page

Verify at the official NPI Registry.