NPIMap

Individual provider Active NPI

Bryan R. Carleton, APRN, DNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Faribault, MN
National Provider Identifier
1902201700
Registry record updated May 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
2593 Issued in MN
Practice address
400 4TH St NW
Faribault, MN 55021-5089
Phone
(507) 384-6830
NPI assigned
Oct 23, 2014
Last updated
May 1, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2025

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 2593 MN Primary

Addresses

Primary practice location

400 4TH St NW
Faribault, MN 55021-5089

Mailing address

400 4TH St NW
Faribault, MN 55021-5089
Phone (507) 384-6830

Other practice location 1

8085 Wayzata Blvd Ste 203
St Louis Park, MN 55426-1461
Phone (612) 296-3800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161212000003 MN Practitioner - Nurse Practitioner 3173847530 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
Southern Cities ClinicGroup PAC ID 7517912991, 6 clinicians

Practice addresses (Care Compare)

400 4TH St NW
Faribault, MN 55021-5031
Phone (507) 384-6830

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2593MNMDRegistered Respiratory Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Cities Community Clinic PastSince Dec 13, 2016 Accepting new patients
Psychotherapy & Healing Associates Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1414022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746057600000",
    "number": "1902201700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 4TH ST NW",
            "city": "FARIBAULT",
            "state": "MN",
            "postal_code": "550215089",
            "telephone_number": "507-384-6830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 4TH ST NW",
            "city": "FARIBAULT",
            "state": "MN",
            "postal_code": "550215089",
            "telephone_number": "507-384-6830"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8085 Wayzata Blvd Ste 203",
            "address_purpose": "LOCATION",
            "city": "St Louis Park",
            "state": "MN",
            "postal_code": "554261461",
            "country_code": "US",
            "telephone_number": "612-296-3800",
            "fax_number": "612-259-7665",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARLETON",
        "first_name": "BRYAN",
        "middle_name": "R.",
        "credential": "APRN, DNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-23",
        "last_updated": "2025-05-01",
        "certification_date": "2025-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "2593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Faribault, MN

Sources for this page

Verify at the official NPI Registry.