Individual provider Active NPI

Amanda Joy Arneson, AGNP-C

  • Gerontology Nurse Practitioner
  • Grand Forks, ND
National Provider Identifier
1932847860
Registry record updated Jul 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
R41305 Issued in ND
Practice address
1380 S Columbia Rd
Grand Forks, ND 58201
Phone
(701) 795-2000
NPI assigned
May 20, 2022
Last updated
Jul 20, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R41305 ND
Gerontology Nurse Practitioner 363LG0600X R41305 ND Primary

Addresses

Primary practice location

1380 S Columbia Rd
Grand Forks, ND 58201

Mailing address

2401 Demers Ave
Grand Forks, ND 58201
Phone (701) 780-6468

Other names 1

  • Amanda Joy Braseth Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
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 1

Enrollment IDStateProvider typePAC IDDetails
I20220811001696 ND Practitioner - Nurse Practitioner 4284017005 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Altru Health SystemGroup PAC ID 1355251604, 675 clinicians

Practice addresses (Care Compare)

1001 7TH St NE
Devils Lake, ND 58301-2719
Phone (701) 662-2157

1300 S Columbia Rd
Grand Forks, ND 58201-4012
Phone (701) 780-5000

1380 S Columbia Rd
Grand Forks, ND 58201-4059
Phone (701) 795-2000

4440 S Washington St
Grand Forks, ND 58201-7245
Phone (701) 780-5000

725 Hamline St
Grand Forks, ND 58203-2819
Phone (701) 780-6800

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R41305NDMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Altru Health System CurrentSince Jul 17, 2022 Accepting new patients
Altru Health System CurrentSince Jul 17, 2022 Accepting new patients
Altru Health System Past Accepting new patients

Locations

1200 S Columbia Rd
Grand Forks, ND 58201
Phone (701) 780-5243

1380 S Columbia Rd
Grand Forks, ND 58201
Phone (701) 795-2000

2401 Demers Ave
Grand Forks, ND 58201
Phone (701) 780-1891

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 2

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": "1653004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658275200000",
    "number": "1932847860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 DEMERS AVE",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "58201",
            "telephone_number": "701-780-6468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1380 S COLUMBIA RD",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "58201",
            "telephone_number": "701-795-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARNESON",
        "first_name": "AMANDA",
        "middle_name": "JOY",
        "credential": "AGNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-20",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ND",
            "license": "R41305",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "ND",
            "license": "R41305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "BRASETH",
            "middle_name": "JOY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Grand Forks, ND

Sources for this page

Verify at the official NPI Registry.