Individual provider Active NPI

Natalie M. Nicholson, NP

  • Nurse Practitioner
  • Bemidji, MN
National Provider Identifier
1962634691
Registry record updated Aug 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R158189-0 Issued in MN
Practice address
802 Paul Bunyan Dr S Ste 12&13
Bemidji, MN 56601-3201
Phone
(218) 444-4323
Fax
(218) 444-7514
NPI assigned
Aug 13, 2009
Last updated
Aug 10, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R158189-0 MN Primary

Addresses

Primary practice location

802 Paul Bunyan Dr S Ste 12&13
Bemidji, MN 56601-3201

Mailing address

802 Paul Bunyan Dr S Ste 12&13
Bemidji, MN 56601-3201
Phone (218) 444-4323

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091211000694 MN Practitioner - Nurse Practitioner 4385784917 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mewinzha Ondaadiziike Wiigaming CurrentSince Jan 1, 2018 Accepting new patients
Mewinzha Ondaadiziike Wiigaming PastSince Jul 11, 2023 Accepting new patients

Locations

802 Paul Bunyan Dr S
Ste 12
Bemidji, MN 56601
Phone (218) 441-4432

802 Paul Bunyan Dr S
Ste 1213
Bemidji, MN 56601
Phone (218) 444-4323

Interoperability endpoints

  • Direct secure messaging: natalie.nicholson.1@26832.direct.athenahealth.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1250121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1962634691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "802 PAUL BUNYAN DR S STE 12&13",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566013201",
            "telephone_number": "218-444-4323",
            "fax_number": "218-444-7514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 PAUL BUNYAN DR S STE 12&13",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566013201",
            "telephone_number": "218-444-4323",
            "fax_number": "218-444-7514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "NATALIE",
        "middle_name": "M.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-13",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "R158189-0",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bemidji, MN

Sources for this page

Verify at the official NPI Registry.