Kimberlie Larson, RN, BSN
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Fargo, ND
NPI 1679390652 · NPPES record last updated Aug 13, 2026
Key facts
- NPI
- 1679390652
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 202733 (ND)
- Practice address
- 2101 Elm St N
Fargo, ND 58102-2417 - Phone
- (218) 234-6600
- NPI assigned
- Sep 23, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- St. Sophie'S LLC
Practice addresses (Care Compare)
3201 33Rd S St
Fargo, ND 58104-8823
3201 33Rd St S
Fargo, ND 58104-8823
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ND
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250907000305 | ND | Practitioner - Nurse Practitioner | 4688176803 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Bachelor on Science - Nursing, Registered Nurse
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Agassiz Associates, PLLC | Current |
Accepting new patients |
Locations
2424 32nd Ave S
Ste 202
Grand Forks, ND 58201
Phone (701) 746-6336
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 202733 | ND | Yes |
| Case Management Registered Nurse | 163WC0400X | R38487 | ND | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 12948 | MN |
Addresses
Primary practice location
2101 Elm St N
Fargo, ND 58102-2417
Mailing address
2101 Elm St N
Fargo, ND 58102-2417
Phone (218) 234-6600
Other providers in Fargo, ND
- Jessica Larson
- Julia Larson
- Julie D Larson
- Kadee Larson
- Kelsey Noel Larson
- Loni Larson
- Mary F Larson
- Megan Elizabeth Larson
- Michael Larson
- Miranda Cathleen Larson
All providers in Fargo, ND · Psychiatric/Mental Health Nurse Practitioner in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 13, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.