Organization Active NPI

North Country Psychiatry

  • Psychiatric/Mental Health Nurse Practitioner
  • Park Rapids, MN
National Provider Identifier
1760078760
Registry record updated Aug 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
NORTH COUNTRY PSYCHIATRY
Practice address
58714 Frazier St
Park Rapids, MN 56470-3053
Phone
(507) 301-6657
NPI assigned
Dec 15, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2024

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

Authorized official

Name
Robert Daun, PMHNPNPI 1649899238
Title
Sole-Member
Phone
(507) 301-2627

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

58714 Frazier St
Park Rapids, MN 56470-3053

Mailing address

58714 Frazier St
Park Rapids, MN 56470-3053
Phone (507) 301-2627

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210315001063 MN Part B Supplier - Clinic/Group Practice 5799191805 Receives reassigned benefits from 1 practitioner
Practice locations: Park Rapids, MN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1607990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722988800000",
    "number": "1760078760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58714 FRAZIER ST",
            "city": "PARK RAPIDS",
            "state": "MN",
            "postal_code": "564703053",
            "telephone_number": "507-301-2627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58714 FRAZIER ST",
            "city": "PARK RAPIDS",
            "state": "MN",
            "postal_code": "564703053",
            "telephone_number": "507-301-6657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH COUNTRY PSYCHIATRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-15",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A",
        "authorized_official_last_name": "DAUN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "SOLE-MEMBER",
        "authorized_official_telephone_number": "507-301-2627",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Park Rapids, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.