Active NPI
Mackensie Marie Brandt, AUD
- Audiologist
- Grand Forks, ND
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 806
- Practice address
- 1200 S Columbia Rd
Grand Forks, ND 58201-4036 - Phone
- (701) 780-5000
- NPI assigned
- Apr 25, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 806 | ND | Primary |
Addresses
Primary practice location
1200 S Columbia Rd
Grand Forks, ND 58201-4036
Mailing address
PO Box 6002
Grand Forks, ND 58206-6002
Phone (701) 780-5000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN, ND
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040907000302 | MN | Practitioner - Qualified Audiologist | 3375519820 | Reassigns benefits to 1 organization |
| I20111222000265 | ND | Practitioner - Qualified Audiologist | 3375519820 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Qualified Audiologist
- Education
- Other, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Altru Health System
Practice addresses (Care Compare)
1001 7TH St NE
Devils Lake, ND 58301-2719
Phone (701) 662-2157
1380 S Columbia Rd
Grand Forks, ND 58201-4059
Phone (701) 795-2000
400 S Minnesota St
Crookston, MN 56716-1808
Phone (218) 281-9100
4440 S Washington St
Grand Forks, ND 58201-7245
Phone (701) 780-5000
711 Delmore Dr
Roseau, MN 56751-1534
Phone (218) 463-1365
715 Delmore Dr
Roseau, MN 56751-1534
Phone (218) 463-2500
Hospital & facility affiliations
- Altru Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 806 | ND | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Altru Health System | Current | Accepting new patients | |
| Altru Health System | Current | Accepting new patients | |
| Altru Health System | Current | Accepting new patients | |
| Altru Health System | Current | Accepting new patients |
Locations
400 S Minnesota St
Crookston, MN 56716
Phone (218) 281-9100
711 Delmore Dr
Roseau, MN 56751
Phone (218) 463-1365
412 Main Ave NE
Warroad, MN 56763
Phone (218) 386-2020
1200 S Columbia Rd
Grand Forks, ND 58201
Phone (701) 780-5243
1380 S Columbia Rd
Grand Forks, ND 58201
Phone (701) 795-2000
1000 S Columbia Rd
Grand Forks, ND 58201
Phone (701) 780-5089
Organizations & group practices 15
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Ambulance
- Grand Forks, ND
- NPI 1114485315
-
- Prosthetic/Orthotic Supplier
- Grand Forks, ND
- NPI 1033257704
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Devils Lake, ND
- NPI 1124117692
-
- Clinic Pharmacy
- Grand Forks, ND
- NPI 1144368085
-
- General Acute Care Hospital
- Grand Forks, ND
- NPI 1154346161
-
- Home Health Agency
- Grand Forks, ND
- NPI 1346339850
-
- Home Infusion Therapy Pharmacy
- Grand Forks, ND
- NPI 1497844906
-
- Clinic/Center
- Grand Forks, ND
- NPI 1811617103
-
- Rural Health Clinic/Center
- Devils Lake, ND
- NPI 1912632449
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Roseau, MN
- NPI 1144518549
Hospital & facility affiliations 1
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": "1177459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1871712166",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6002",
"city": "GRAND FORKS",
"state": "ND",
"postal_code": "582066002",
"telephone_number": "701-780-5000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 S COLUMBIA RD",
"city": "GRAND FORKS",
"state": "ND",
"postal_code": "582014036",
"telephone_number": "701-780-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRANDT",
"first_name": "MACKENSIE",
"middle_name": "MARIE",
"credential": "AUD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "ND",
"license": "806",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"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 Jul 8, 2007; 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.