Individual provider Active NPI

Carissa Abigail Monique Lawrence, CNM/WHNP-BC

  • Advanced Practice Midwife
  • Fargo, ND
National Provider Identifier
1891265757
Registry record updated Aug 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
Practice address
5225 23Rd Ave S
Fargo, ND 58104-7927
Phone
(701) 417-2000
NPI assigned
Dec 4, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 104421645 MA
Advanced Practice Midwife 367A00000X Primary

Addresses

Primary practice location

5225 23Rd Ave S
Fargo, ND 58104-7927

Mailing address

5 Bay State Rd
Worcester, MA 01606-2101
Phone (718) 207-0625

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND, SD2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190828003389 ND Practitioner - Certified Nurse Midwife (CNM) 2961730908 Reassigns benefits to 1 organization
I20220902002330 SD Practitioner - Certified Nurse Midwife (CNM) 2961730908 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
82.73 of 100Reported as group
Quality
71.75
Promoting interoperability
100
Improvement activities
40
Cost
70.68

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
104421645MAMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Medical Center Fargo CurrentSince Jun 15, 2019 Accepting new patients
Sanford Medical Center Fargo CurrentSince Jun 15, 2019 Accepting new patients
Sanford Medical Center CurrentSince Jun 14, 2022 Accepting new patients

Locations

5225 23rd Ave S
Fargo, ND 58104
Phone (701) 234-5933

2400 32nd Ave S
Fargo, ND 58103
Phone (701) 234-8800

1220 Sheyenne St
West Fargo, ND 58078
Phone (701) 234-4445

4405 E 26th St
Sioux Falls, SD 57103
Phone (605) 328-9000

Organizations & group practices 3

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": "1543881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659657600000",
    "number": "1891265757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 BAY STATE RD",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016062101",
            "telephone_number": "718-207-0625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5225 23RD AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581047927",
            "telephone_number": "701-417-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWRENCE",
        "first_name": "CARISSA",
        "middle_name": "ABIGAIL MONIQUE",
        "name_prefix": "Ms.",
        "credential": "CNM/WHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-04",
        "last_updated": "2022-08-05",
        "certification_date": "2022-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MA",
            "license": "104421645",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.