Individual provider Active NPI

Marlena Kennedy, ND

  • Naturopath
  • Grand Forks, ND
National Provider Identifier
1831673474
Registry record updated Nov 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
NaturopathTaxonomy code 175F00000X
License
2022-01 Issued in ND
Practice address
2860 19TH Ave S
Grand Forks, ND 58201-5957
Phone
(701) 314-9904
NPI assigned
Sep 19, 2018
Last updated
Nov 25, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Naturopath 175F00000X 4187 OR
Naturopath 175F00000X 2022-01 ND Primary

Addresses

Primary practice location

2860 19TH Ave S
Grand Forks, ND 58201-5957

Mailing address

2860 19TH Ave S
Grand Forks, ND 58201-5957
Phone (701) 314-9904

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL fax

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2022-01NDMDNaturopath
4187ORMDNaturopath

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Natural Medicine PLLC Naturopath CurrentSince Nov 27, 2022 Accepting new patients
Marlena Kurtz LLC Naturopath CurrentSince Feb 16, 2020 Accepting new patients

Locations

2860 19th Ave S
Grand Forks, ND 58201
Phone (218) 643-9330

130 NW Miller Ave
Gresham, OR 97030
Phone (503) 655-2344

500 NW 20th St
Ste 101
Gresham, OR 97030
Phone (503) 665-2344

Organizations & group practices 2

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": "1537315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669334400000",
    "number": "1831673474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2860 19TH AVE S",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582015957",
            "telephone_number": "701-314-9904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2860 19TH AVE S",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582015957",
            "telephone_number": "701-314-9904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "MARLENA",
        "name_prefix": "Dr.",
        "credential": "ND",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-19",
        "last_updated": "2022-11-25",
        "certification_date": "2022-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "OR",
            "license": "4187",
            "primary": false
        },
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "ND",
            "license": "2022-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "fax",
            "affiliation": "N",
            "address_1": "2860 19th Ave S",
            "city": "Grand Forks",
            "state": "ND",
            "country_code": "US",
            "postal_code": "582015957",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Grand Forks, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.