NPIMap

Individual provider Active NPI

Richard Lee Fraser, NP

  • Family Nurse Practitioner
  • Duluth, MN
National Provider Identifier
1891748000
Registry record updated Jan 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
6433 Issued in MN
Practice address
4190 Loberg Ave
Duluth, MN 55811-2652
Phone
(218) 249-5700
Fax
(218) 249-4666
NPI assigned
May 18, 2006
Last updated
Jan 19, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 851-033 WI
Family Nurse Practitioner 363LF0000X 6433 MN Primary

Addresses

Primary practice location

4190 Loberg Ave
Duluth, MN 55811-2652

Mailing address

4190 Loberg Ave
Duluth, MN 55811-2652
Phone (218) 249-5700

Other practice location 1

6951 S Michigan St
Three Lakes, WI 54562-9281
Phone (715) 546-3375

Other identifiers 1

IdentifierTypeStateIssuer
43857200MedicaidWI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address him@slk.direct.slhduluth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, MN2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20051026000650 WI Practitioner - Nurse Practitioner 4082631387 Reassigns benefits to 5 organizations
I20190507001745 MN Practitioner - Nurse Practitioner 4082631387 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. Luke's Hospital of DuluthGroup PAC ID 7113834839, 409 clinicians

Practice addresses (Care Compare)

1011 E 1St St
Duluth, MN 55805-2242
Phone (218) 249-7000

1015 E 1St St
Duluth, MN 55805-2242
Phone (218) 249-7860

1120 E 34TH St
Hibbing, MN 55746-2909
Phone (218) 362-7100

4190 Loberg Ave
Duluth, MN 55811-2652
Phone (218) 249-4600

915 E 1St St
Duluth, MN 55805-2107
Phone (218) 249-5439

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
6433MNMDChiropractor
851WIMDAcupuncturist
851-033WIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke's Hospital of Duluth CurrentSince May 28, 2019 Accepting new patients
Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc. CurrentSince Apr 1, 2010 Accepting new patients
The Howard Young Medical Center, Inc. CurrentSince May 17, 2008 Accepting new patients
Aspirus Eagle River Hospital & Clinics, Inc. CurrentSince May 10, 2008 Accepting new patients
Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc. CurrentSince Apr 1, 2010 Accepting new patients
Memorial Medical Center Inc CurrentSince Jun 1, 2024 Accepting new patients
St. Luke's Hospital of Duluth Current Accepting new patients
St. Luke's Hospital of Duluth CurrentSince May 28, 2019 Accepting new patients
Aspirus Eagle River Hospital, Inc. CurrentSince May 10, 2008 Accepting new patients
Memorial Medical Center Inc CurrentSince Jun 1, 2024 Accepting new patients
St. Luke's Hospital of Duluth CurrentSince May 28, 2019 Accepting new patients
St. Luke's Hospital of Duluth Current Accepting new patients
St. Luke's Hospital of Duluth Past Accepting new patients
Medical Services, Inc Past Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

1015 E 1st St
Duluth, MN 55805
Phone (218) 249-7860

619 W Central Entrance
Duluth, MN 55811
Phone (218) 249-4987

915 E 1st St
Duluth, MN 55805
Phone (218) 249-5352

4190 Loberg Ave
Hermantown, MN 55811
Phone (218) 249-4600

1120 E 34th St
Hibbing, MN 55746
Phone (218) 263-7455

8373 Unity Dr
Virginia, MN 55792
Phone (218) 748-7421

1615 Maple Ln
Ashland, WI 54806
Phone (715) 682-4563

400 W Glen St
Crandon, WI 54520
Phone (715) 478-3318

201 Hospital Rd
Eagle River, WI 54521
Phone (715) 477-3000

1020 Kabel Ave
Rhinelander, WI 54501
Phone (715) 361-2805

2251 N Shore Dr
Ste 100
Rhinelander, WI 54501
Phone (715) 361-2074

444 E Timber Dr
Rhinelander, WI 54501
Phone (715) 369-2300

109 N 28th St E
Superior, WI 54880
Phone (715) 395-3900

6951 S Michigan St
Three Lakes, WI 54562
Phone (715) 546-2543

401 W Mohawk Dr
Ste 100
Tomahawk, WI 54487
Phone (715) 453-7700

240 Maple St
Woodruff, WI 54568
Phone (715) 356-8000

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 26

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

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611014400000",
    "number": "1891748000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4190 LOBERG AVE",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558112652",
            "telephone_number": "218-249-5700",
            "fax_number": "218-249-4666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4190 LOBERG AVE",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558112652",
            "telephone_number": "218-249-5700",
            "fax_number": "218-249-4666"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6951 S Michigan St",
            "address_purpose": "LOCATION",
            "city": "Three Lakes",
            "state": "WI",
            "postal_code": "545629281",
            "country_code": "US",
            "telephone_number": "715-546-3375",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FRASER",
        "first_name": "RICHARD",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "851-033",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "6433",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43857200",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@slk.direct.slhduluth.com",
            "affiliation": "N",
            "address_1": "4190 Loberg Ave",
            "city": "Duluth",
            "state": "MN",
            "country_code": "US",
            "postal_code": "558112652",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.