Individual provider Active NPI

Ann Marie Burgeson, BSN, RN. MSN NP-C

  • Family Nurse Practitioner
  • Moorhead, MN
National Provider Identifier
1740394824
Registry record updated Jan 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CNP 0613 Issued in MN
Practice address
2310 4TH Ave N
Moorhead, MN 56560-2473
Phone
(218) 236-6502
NPI assigned
Aug 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R 168305-7 MN
Family Nurse Practitioner 363LF0000X R 168305-7 MN
Family Nurse Practitioner 363LF0000X CNP 0613 MN Primary

Addresses

Primary practice location

2310 4TH Ave N
Moorhead, MN 56560-2473

Mailing address

2310 4TH Ave N
Moorhead, MN 56560-2473
Phone (218) 236-6502

Other practice location 1

9555 Upland Ln N
Maple Grove, MN 55369-4485
Phone (952) 993-1440

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080516000544 MN Practitioner - Nurse Practitioner 8628147642 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor on Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R 168305-7MNMDNurse Practitioner
CNP 0613MNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Park Nicollet Clinic CurrentSince Dec 11, 2023 Accepting new patients
Group Health, Inc. CurrentSince Dec 11, 2023 Accepting new patients
Group Health, Inc. CurrentSince Dec 11, 2023 Accepting new patients
Park Nicollet Clinic CurrentSince Dec 11, 2023 Accepting new patients

Locations

9555 Upland Ln N
Maple Grove, MN 55369
Phone (952) 993-1440

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375

5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400

Interoperability endpoints

  • Direct secure messaging: annmarie.burgeson@292123710390276.direct.elationemr.com

Organizations & group practices 4

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": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736899200000",
    "number": "1740394824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2310 4TH AVE N",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565602473",
            "telephone_number": "218-236-6502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2310 4TH AVE N",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565602473",
            "telephone_number": "218-236-6502"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9555 Upland Ln N",
            "address_purpose": "LOCATION",
            "city": "Maple Grove",
            "state": "MN",
            "postal_code": "553694485",
            "country_code": "US",
            "telephone_number": "952-993-1440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURGESON",
        "first_name": "ANN MARIE",
        "name_prefix": "Mrs.",
        "credential": "BSN, RN. MSN NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-18",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "R 168305-7",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "R 168305-7",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "CNP 0613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moorhead, MN

Sources for this page

Verify at the official NPI Registry.