Individual provider Active NPI

Georgeanna Dul Knutson, CNP

  • Nurse Practitioner
  • Saint Cloud, MN
National Provider Identifier
1811080104
Registry record updated Sep 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R-115788-4 Issued in MN
Practice address
1900 Centracare Cir
Suite 500
Saint Cloud, MN 56303-5000
Phone
(320) 229-5099
Fax
(320) 229-5171
NPI assigned
Oct 1, 2006
Last updated
Sep 12, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R-115788-4 MN Primary

Addresses

Primary practice location

1900 Centracare Cir
Suite 500
Saint Cloud, MN 56303-5000

Mailing address

1900 Centracare Cir
Suite 500
Saint Cloud, MN 56303-5000
Phone (320) 229-5099

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
I20061219000047 MN Practitioner - Nurse Practitioner 2961401005 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Select Urgent Care LLCGroup PAC ID 1658762646, 14 clinicians

Practice addresses (Care Compare)

190 Central Ave S
Milaca, MN 56353-1123
Phone (218) 824-5027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R-115788-4MNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Health Services Current Accepting new patients
Fairview Health Services CurrentSince Jun 30, 2012 Accepting new patients
Select Urgent Care LLC CurrentSince Mar 30, 2022 Accepting new patients
Fairview Health Services Nurse Practitioner CurrentSince Jun 30, 2012 Accepting new patients
Select Therapy, Inc. PastSince Mar 30, 2022 Accepting new patients
Lakeside Medical Center, Inc. Past Accepting new patients
Minnesota Oncology Hematology, PA Past Accepting new patients
Allina Health System Past Accepting new patients

Locations

14101 Fairview Dr
Ste 300
Burnsville, MN 55337
Phone (612) 273-5400

5836 Blaine Ave
Inver Grove Heights, MN 55076
Phone (651) 455-0535

190 Central Ave S
Milaca, MN 56353
Phone (224) 487-4368

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

2450 Riverside Ave
Ste F140
Minneapolis, MN 55454
Phone (651) 464-4847

516 Delaware St SE
Minneapolis, MN 55455
Phone (612) 625-3600

129 6th Ave SE
Pine City, MN 55063
Phone (320) 629-2542

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

3300 Oakdale Ave N
Ste 200
Robbinsdale, MN 55422
Phone (763) 520-2000

Interoperability endpoints

  • Direct secure messaging: georgeanna.knutson.1@28265.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/28265/brand/1/csg/1/fhir/r4

Organizations & group practices 9

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": "1159660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473638400000",
    "number": "1811080104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 CENTRACARE CIR",
            "address_2": "SUITE 500",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563035000",
            "telephone_number": "320-229-5099",
            "fax_number": "320-229-5171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 CENTRACARE CIR",
            "address_2": "SUITE 500",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563035000",
            "telephone_number": "320-229-5099",
            "fax_number": "320-229-5171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNUTSON",
        "first_name": "GEORGEANNA",
        "middle_name": "DUL",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-01",
        "last_updated": "2016-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "R-115788-4",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, MN

Sources for this page

Verify at the official NPI Registry.