Active NPI
Danielle Lin Magness-Wellmann, DO
- Psychiatry Physician
- Mankato, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 55114
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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
Enrollment records 1
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
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125054660 | IL | MD | Psychiatry Physician |
| 55114 | MN | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mankato Clinic LTD | Psychiatry | Current | 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
- 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.
-
- General Acute Care Hospital
- Fairmont, MN
- NPI 1821066499
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.