NPIMap

Individual provider Active NPI

Karissa Marie Schultz, APRN, CNP

  • Adult Health Nurse Practitioner
  • Deer River, MN
National Provider Identifier
1902258502
Registry record updated Apr 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
4700 Issued in MN
Practice address
115 10TH Avenue NE Suite a
Essentia Health Deer River Clinic
Deer River, MN 56636-8795
Phone
(218) 246-8275
Fax
(218) 246-8279
NPI assigned
Jul 7, 2016
Last updated
Apr 16, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R37224 ND
Adult Health Nurse Practitioner 363LA2200X 2366124 MN
Adult Health Nurse Practitioner 363LA2200X 4700 MN Primary
Primary Care Nurse Practitioner 363LP2300X R37224 ND

Addresses

Primary practice location

115 10TH Avenue NE Suite a
Essentia Health Deer River Clinic
Deer River, MN 56636-8795

Mailing address

Essentia Health Duluth Clinic MSS 6Av1-Pe
400 East Third Street
Duluth, MN 55805-1951
Phone (218) 786-1183

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
I20171019000270 MN Practitioner - Nurse Practitioner 4789977562 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Deer River Healthcare Center IncGroup PAC ID 1850388448, 14 clinicians

Practice addresses (Care Compare)

115 10TH Ave NE
Deer River, MN 56636-8795

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4700MNMDMarriage & Family Therapist
R37224NDMDNurse Practitioner
2366124MNMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Deer River Healthcare Center Inc CurrentSince Oct 16, 2017 Accepting new patients
The Duluth Clinic LTD CurrentSince Apr 9, 2018 Accepting new patients
Deer River Healthcare Center, Inc. CurrentSince Oct 16, 2017 Accepting new patients
Deer River Healthcare Center, Inc. Current Accepting new patients
The Duluth Clinic, LTD. CurrentSince Apr 9, 2018 Accepting new patients
The Duluth Clinic LTD Current Accepting new patients
Deer River Healthcare Center, Inc Past Accepting new patients

Locations

115 10th Ave NE
Deer River, MN 56636
Phone (218) 246-2900

115 10th Ave NE
#A
Deer River, MN 56636
Phone (218) 246-8275

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

400 E 3rd St
#2
Duluth, MN 55805
Phone (218) 786-8319

Organizations & group practices 7

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 10

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": "1467849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586995200000",
    "number": "1902258502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ESSENTIA HEALTH DULUTH CLINIC MSS 6AV1-PE",
            "address_2": "400 EAST THIRD STREET",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-786-1183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 10TH AVENUE NE SUITE A",
            "address_2": "ESSENTIA HEALTH DEER RIVER CLINIC",
            "city": "DEER RIVER",
            "state": "MN",
            "postal_code": "566368795",
            "telephone_number": "218-246-8275",
            "fax_number": "218-246-8279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHULTZ",
        "first_name": "KARISSA",
        "middle_name": "MARIE",
        "credential": "APRN, CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-07",
        "last_updated": "2020-04-16",
        "certification_date": "2020-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ND",
            "license": "R37224",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MN",
            "license": "2366124",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MN",
            "license": "4700",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "ND",
            "license": "R37224",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deer River, MN

Sources for this page

Verify at the official NPI Registry.