Individual provider Active NPI

Nakita Grace Natala, M.D.

  • Psychiatry Physician
  • Bloomington, MN
National Provider Identifier
1699114975
Registry record updated Feb 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
66270 Issued in MN
Practice address
1801 American Blvd E
Bloomington, MN 55425-1232
Phone
(612) 253-1111
Fax
(952) 767-0782
NPI assigned
Jun 19, 2013
Last updated
Feb 27, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 4301102853 MI
Psychiatry Physician 2084P0800X 66270 MN Primary
Child & Adolescent Psychiatry Physician 2084P0804X 66270 MN

Addresses

Primary practice location

1801 American Blvd E
Bloomington, MN 55425-1232

Mailing address

1801 American Blvd E
Bloomington, MN 55425-1232
Phone (612) 253-1111

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
I20190912002114 MN Practitioner - Psychiatry 9133439276 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301102853MIMDPsychiatry Physician
66270MNMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fraser Child and Family Center CurrentSince Nov 4, 2024 Accepting new patients
Fraser PastSince Jan 1, 2025 Accepting new patients
Univerisity of Michigan Health System Past Accepting new patients

Locations

9120 Springbrook Dr NW
Minneapolis, MN 55433
Phone (763) 231-2590

2400 W 64th St
Richfield, MN 55423
Phone (612) 767-5166

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1371600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740614400000",
    "number": "1699114975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 AMERICAN BLVD E",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554251232",
            "telephone_number": "612-253-1111",
            "fax_number": "952-767-0782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 AMERICAN BLVD E",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554251232",
            "telephone_number": "612-253-1111",
            "fax_number": "952-767-0782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NATALA",
        "first_name": "NAKITA",
        "middle_name": "GRACE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-19",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301102853",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MN",
            "license": "66270",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MN",
            "license": "66270",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, MN

Sources for this page

Verify at the official NPI Registry.