Individual provider Active NPI

Angela Danette Christian, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Grand Rapids, MN
National Provider Identifier
1891186482
Registry record updated Aug 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
223029-2 Issued in MN
Practice address
215 SE 2ND Ave
Grand Rapids, MN 55744-3615
Phone
(218) 326-1151
Fax
(218) 326-6085
NPI assigned
Feb 18, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 223029-2 MN Primary

Addresses

Primary practice location

215 SE 2ND Ave
Grand Rapids, MN 55744-3615

Mailing address

215 SE 2ND Ave
Grand Rapids, MN 55744-3615
Phone (218) 326-1151

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, TN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150421001258 MN Practitioner - Nurse Practitioner 8325366453 Reassigns benefits to 1 organization
I20210913002525 TN Practitioner - Nurse Practitioner 8325366453 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northland Counseling Center IncGroup PAC ID 1153389242, 25 clinicians

Practice addresses (Care Compare)

215 SE 2ND Ave
Grand Rapids, MN 55744-3615
Phone (218) 327-1151

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
223029-2MNMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northland Counseling Center, Inc. CurrentSince Mar 16, 2015 Accepting new patients

Locations

215 SE 2nd Ave
Grand Rapids, MN 55744
Phone (218) 326-1274

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1424217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1891186482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 SE 2ND AVE",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557443615",
            "telephone_number": "218-326-1151",
            "fax_number": "218-326-6085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 SE 2ND AVE",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557443615",
            "telephone_number": "218-326-1151",
            "fax_number": "218-326-6085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTIAN",
        "first_name": "ANGELA",
        "middle_name": "DANETTE",
        "name_prefix": "Mrs.",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-18",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "223029-2",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MN

Sources for this page

Verify at the official NPI Registry.