Alicia Marjorie Wolfgram, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

R29493 Issued in ND

Practice address

1200 S Columbia Rd - Altru Hospital
Grand Forks, ND 58201

Phone

(701) 780-6000

NPI assigned

Feb 14, 2012

Last updated

Mar 26, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Alicia Marjorie Wirth Former name

Medicare fee-for-service enrollment

Enrolled in ND

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Altru Health SystemGroup PAC ID 1355251604, 675 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Altru Hospital Hospital, Grand Forks, ND, CCN 350019

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Altru Health System

  dba Altru 1300 Columbia

  • Clinic/Center
  • Grand Forks, ND
  • NPI 1043309552
  Medicare reassignment Care Compare group NPD
• Northwood Deaconess Health Center

  • Critical Access Hospital
  • Northwood, ND
  • NPI 1356449136
  Medicare reassignment NPD
• Altru Health System

  • General Acute Care Hospital
  • Grand Forks, ND
  • NPI 1154346161
  NPD
• Northwood Deaconess Health Center

  • Rural Health Clinic/Center
  • Binford, ND
  • NPI 1023550118
  NPD
• Northwood Deaconess Health Center

  • Rural Health Clinic/Center
  • Northwood, ND
  • NPI 1477964674
  NPD

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

• Altru Health System

  • General Acute Care Hospital
  • Grand Forks, ND
  • NPI 1154346161
  Care Compare affiliation

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

{
    "created_epoch": "1329177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553558400000",
    "number": "1851664304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 DEMERS AVE",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "58201",
            "telephone_number": "701-780-1891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 S COLUMBIA RD - ALTRU HOSPITAL",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "58201",
            "telephone_number": "701-780-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLFGRAM",
        "first_name": "ALICIA",
        "middle_name": "MARJORIE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-14",
        "last_updated": "2019-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ND",
            "license": "R29493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALICIA",
            "last_name": "WIRTH",
            "middle_name": "MARJORIE",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Karina Wittmann, LRD
• Sarah Wocken, M.A., CCC-SLP
• Jordan James Wojnarski, MS CF SLP
• Brady Wold-Heyen, PT, DPT
• Holly J Wolf, PH.D.
• James Rese Wood, MD
• Jason Paul Wood, LPCC
• Kayla Ann Wood
• Trista Wood
• Richard Charles Woodbeck Jr., OPA-C, OTC, OT-SC

• Certified Registered Nurse Anesthetist in Grand Forks, ND
• Providers in Grand Forks, ND by specialty
• Certified Registered Nurse Anesthetist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.