NPIMap

Individual provider Active NPI

Amanda Carol Houghtaling, FNP

  • Family Nurse Practitioner
  • Pelican Rapids, MN
National Provider Identifier
1770090094
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5631 Issued in MN
Practice address
211 E Mill St
Pelican Rapids, MN 56572-4234
Phone
(218) 863-6100
NPI assigned
Jan 8, 2018
Last updated
Dec 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5631 MN Primary

Addresses

Primary practice location

211 E Mill St
Pelican Rapids, MN 56572-4234

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180305002002 MN Practitioner - Nurse Practitioner 4789945908 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Perham Hospital DistrictGroup PAC ID 2264327766, 40 clinicians
Sanford Medical Center FargoGroup PAC ID 8426967803, 1,210 clinicians

Practice addresses (Care Compare)

1000 Coney St W
Perham, MN 56573-2102
Phone (218) 347-1200

1412 Main St
Hawley, MN 56549
Phone (218) 483-3564

211 E Mill St
Pelican Rapids, MN 56572-4234
Phone (218) 863-6100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.39 of 100Reported as group
Quality
91.62
Promoting interoperability
100
Improvement activities
40
Cost
66.36

Merit-based Incentive Payment System (MIPS)

Final score
88.99 of 100Reported as group
Quality
92.39
Promoting interoperability
100
Improvement activities
40
Cost
70.9

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Medical Center Fargo CurrentSince Oct 13, 2024 Accepting new patients
Perham Hospital District CurrentSince Jan 29, 2018 Accepting new patients
Sanford Medical Center Fargo CurrentSince Oct 13, 2024 Accepting new patients
Perham Hospital District CurrentSince Jan 29, 2018 Accepting new patients
Perham Hospital District Current Accepting new patients
Sanford Clinic North Past Accepting new patients

Locations

4000 28th Ave S
Moorhead, MN 56560
Phone (701) 234-3200

211 E Mill St
Pelican Rapids, MN 56572
Phone (218) 863-6100

1000 Coney St W
Perham, MN 56573
Phone (218) 347-1200

Organizations & group practices 6

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1515369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1770090094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 E MILL ST",
            "city": "PELICAN RAPIDS",
            "state": "MN",
            "postal_code": "565724234",
            "telephone_number": "218-863-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOUGHTALING",
        "first_name": "AMANDA",
        "middle_name": "CAROL",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-08",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "5631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pelican Rapids, MN

Sources for this page

Verify at the official NPI Registry.