Individual provider Active NPI

Laura Ann Kroetsch, MD

  • Psychiatry Physician
  • Fargo, ND
National Provider Identifier
1740382456
Registry record updated Sep 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
10120 Issued in ND
Practice address
2624 9TH Ave S
Fargo, ND 58103-2350
Phone
(701) 298-4500
Fax
(701) 298-4400
NPI assigned
Sep 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 10120 ND Primary

Addresses

Primary practice location

2624 9TH Ave S
Fargo, ND 58103-2350

Mailing address

2624 9TH Ave S
Fargo, ND 58103-2350
Phone (701) 298-4500

Other identifiers 4

IdentifierTypeStateIssuer
635192100MedicaidMN
13648MedicaidND
274G0BEOtherMNMNBCBS
26319OtherNDNDBCBS

Other names 1

  • Laura Ann Berg Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
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
I20051229000552 ND Practitioner - Psychiatry 9234151572 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of North Dakota School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lake Region Human Service CenterGroup PAC ID 8426941436, 16 clinicians

Practice addresses (Care Compare)

200 Hwy 2 SW
Devils Lake, ND 58301-3532

200 Hwy 2 W
Devils Lake, ND 58301-3532
Phone (701) 665-2200

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Region Behavioral Health Clinic CurrentSince Nov 8, 2023 Accepting new patients
Northeast Behavioral Health Clinic CurrentSince Jan 1, 2025 Accepting new patients
West Central Behavioral Health Clinic CurrentSince Dec 1, 2024 Accepting new patients
Badlands Behavioral Health Clinic CurrentSince Aug 1, 2022 Accepting new patients
North Central Behavioral Health Clinic CurrentSince Oct 10, 2023 Accepting new patients
Northeast Human Service Center CurrentSince Jan 1, 2025 Accepting new patients
South Central Behavioral Health Clinic CurrentSince Jan 1, 2025 Accepting new patients
Northwest Behavioral Health Clinic CurrentSince Oct 10, 2023 Accepting new patients
Center for Psychiatric Care Psychiatry PastSince Aug 28, 2000 Accepting new patients
Badlands Behavioral Health Clinic PastSince Aug 1, 2022 Accepting new patients

Locations

1237 W Divide Ave
Ste 5
Bismarck, ND 58501
Phone (701) 328-8888

600 E Boulevard Ave
Dept 325
Bismarck, ND 58505
Phone (701) 328-4644

200 Highway 2 W
Devils Lake, ND 58301
Phone (701) 665-2200

1463 I94 Business Loop E
Dickinson, ND 58601
Phone (701) 227-7500

151 S 4th St
Ste 401
Grand Forks, ND 58201
Phone (701) 795-3000

520 3rd St NW
Jamestown, ND 58401
Phone (701) 253-6300

1015 S Broadway
Ste 18
Minot, ND 58701
Phone (701) 857-8500

316 2nd Ave W
Williston, ND 58801
Phone (701) 774-4600

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220572800000",
    "number": "1740382456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2624 9TH AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581032350",
            "telephone_number": "701-298-4500",
            "fax_number": "701-298-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2624 9TH AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581032350",
            "telephone_number": "701-298-4500",
            "fax_number": "701-298-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KROETSCH",
        "first_name": "LAURA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-02",
        "last_updated": "2008-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "ND",
            "license": "10120",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "635192100",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "13648",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MNBCBS",
            "identifier": "274G0BE",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NDBCBS",
            "identifier": "26319",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "BERG",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.