Individual provider Active NPI

Mackensie Marie Brandt, AUD

  • Audiologist
  • Grand Forks, ND
National Provider Identifier
1871712166
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
806 Issued in ND
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

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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, ND2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
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 675 clinicians

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 Hospital, Grand Forks, ND, CCN 350019

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
806NDMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Altru Health System Current Accepting new patients
Altru Health System CurrentSince Jul 14, 2011 Accepting new patients
Altru Health System CurrentSince Jun 19, 2001 Accepting new patients
Altru Health System CurrentSince Jun 19, 2001 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.

View all 15

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.

Verify at the official NPI Registry.