Active NPI
Marlene Ann Wood, NP
- Nurse Practitioner
- Elbow Lake, MN
National Provider Identifier
1952384489
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- RO709136
- Practice address
- 1411 State Hwy 79 East
Elbow Lake, MN 56531-4611 - Phone
- (218) 685-4461
- NPI assigned
- Nov 29, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | RO709136 | MN | Primary |
Addresses
Primary practice location
1411 State Hwy 79 East
Elbow Lake, MN 56531-4611
Mailing address
712 S Cascade St
Fergus Falls, MN 56537-2913
Phone (218) 736-8000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 816814800 | Medicaid | MN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RO709136 | MN | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lake Region Healthcare Corporation | Current | Accepting new patients | |
| Lake Region Healthcare Corporation | Current | Accepting new patients | |
| Lake Region Healthcare Corporation | Current | Accepting new patients | |
| Lake Region Healthcare Corporation | Current | Accepting new patients |
Locations
1411 Highway 79 E
Elbow Lake, MN 56531
Phone (218) 685-7300
649 State St NW
Evansville, MN 56326
Phone (218) 948-2040
712 S Cascade St
Fergus Falls, MN 56537
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/e35355ac-dfca-48b9-9dd9-0b7c408c2a66/
Organizations & group practices 4
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.
-
- Critical Access Hospital
- Elbow Lake, MN
- NPI 1407838329
-
- General Acute Care Hospital
- Fergus Falls, MN
- NPI 1093713372
-
- Chiropractor
- Fergus Falls, MN
- NPI 1265148480
-
- Durable Medical Equipment & Medical Supplies
- Fergus Falls, MN
- NPI 1942191119
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133222400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1487548800000",
"number": "1952384489",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "712 S CASCADE ST",
"city": "FERGUS FALLS",
"state": "MN",
"postal_code": "565372913",
"telephone_number": "218-736-8000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1411 STATE HWY 79 EAST",
"city": "ELBOW LAKE",
"state": "MN",
"postal_code": "565314611",
"telephone_number": "218-685-4461"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOOD",
"first_name": "MARLENE",
"middle_name": "ANN",
"name_prefix": "Ms.",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-29",
"last_updated": "2017-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MN",
"license": "RO709136",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "816814800",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Elbow Lake, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.