Individual provider Active NPI

Danielle Lin Magness-Wellmann, DO

  • Psychiatry Physician
  • Mankato, MN
National Provider Identifier
1679729164
Registry record updated Aug 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
55114 Issued in MN
Practice address
1400 Madison Ave Suite 352
Mankato Clinic Department of Psychiatry and Psychology
Mankato, MN 56001
Phone
(507) 625-1811
NPI assigned
Aug 15, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 55114 MN Primary
Psychiatry Physician 2084P0800X 125054660 IL

Addresses

Primary practice location

1400 Madison Ave Suite 352
Mankato Clinic Department of Psychiatry and Psychology
Mankato, MN 56001

Mailing address

PO Box 8674 1230 E. Main Street
Mankato Clinic, LTD
Mankato, MN 56002-8674
Phone (507) 625-1811

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address daniellemagnesswellmann@mklt.allscriptsdirect.net Direct

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120804000035 MN Practitioner - Psychiatry 8123274396 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Midwestern University, Chicago College of Osteopathic Med, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mankato Clinic LTDGroup PAC ID 5597677955, 243 clinicians

Practice addresses (Care Compare)

118 Raven CT
Mankato, MN 56001-8431
Phone (507) 388-3660

1230 E Main St
Mankato, MN 56001-5066
Phone (507) 389-8509

1230 Main St E
PO Box 8674
Mankato, MN 56002-8674
Phone (507) 625-1811

1400 Madison Ave
Suite 352
Mankato, MN 56001-4458
Phone (507) 625-1811

1411 Premier Dr
Mankato, MN 56001-6076
Phone (507) 388-6000

1421 Premier Dr
Mankato, MN 56001-6076
Phone (507) 385-4000

1431 Premier Dr
Mankato, MN 56001-6076
Phone (507) 386-6750

1431 Premier Dr MRI Dept
Orthopaedic and Fracture Clinic
Mankato, MN 56001-6076
Phone (507) 386-6750

1575 Lookout Dr
North Mankato, MN 56003-2503
Phone (507) 625-5027

1901 Old Minnesota Ave
Saint Peter, MN 56082-1763
Phone (504) 934-2325

Hospital & facility affiliations

  • Mayo Clinic Health System - Fairmont Hospital, Fairmont, MN, CCN 240166

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
125054660ILMDPsychiatry Physician
55114MNMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mankato Clinic LTD Psychiatry CurrentSince Aug 1, 2012 Accepting new patients

Locations

1025 Marsh St
Mankato, MN 56001
Phone (507) 345-2623

1400 Madison Ave
Ste 352
Mankato, MN 56001
Phone (507) 387-3195

1324 5th St N
New Ulm, MN 56073
Phone (507) 217-5000

Interoperability endpoints

  • Direct secure messaging: daniellemagnesswellmann@mklt.allscriptsdirect.net

Organizations & group practices 1

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 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": "1218758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1679729164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8674 1230 E. MAIN STREET",
            "address_2": "MANKATO CLINIC, LTD",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560028674",
            "telephone_number": "507-625-1811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 MADISON AVE SUITE 352",
            "address_2": "MANKATO CLINIC DEPARTMENT OF PSYCHIATRY AND PSYCHOLOGY",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "56001",
            "telephone_number": "507-625-1811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGNESS-WELLMANN",
        "first_name": "DANIELLE",
        "middle_name": "LIN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-15",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MN",
            "license": "55114",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "125054660",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "daniellemagnesswellmann@mklt.allscriptsdirect.net",
            "affiliation": "N",
            "endpointDescription": "Mankato Clinic Direct ID, Allscripts Community",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1400 Madison Ave Suite 352",
            "address_2": "Mankato Clinic Department of Psychiatry and Psychology",
            "city": "Mankato",
            "state": "MN",
            "country_code": "US",
            "postal_code": "56001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mankato, MN

Sources for this page

Verify at the official NPI Registry.