Individual provider Active NPI

Kristen Marie Young, FNP

  • Family Nurse Practitioner
  • Grand Forks, ND
National Provider Identifier
1982210308
Registry record updated Sep 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R33316 Issued in ND
Practice address
212 S 4TH St Ste 301
Grand Forks, ND 58201-4776
Phone
(701) 757-2100
Fax
(701) 757-0305
NPI assigned
Sep 21, 2020
Last updated
Sep 21, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R33316 ND Primary

Addresses

Primary practice location

212 S 4TH St Ste 301
Grand Forks, ND 58201-4776

Mailing address

212 S 4TH St Ste 301
Grand Forks, ND 58201-4776
Phone (701) 757-2100

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
I20201228000362 ND Practitioner - Nurse Practitioner 0840602439 Reassigns benefits to 3 organizations

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
Spectra HealthGroup PAC ID 8022075258, 12 clinicians

Practice addresses (Care Compare)

607 Tower Ave
Larimore, ND 58251
Phone (701) 343-6418

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R33316NDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Spectra Health CurrentSince Oct 7, 2020 Accepting new patients
Cooperstown Medical Center Current Accepting new patients
Spectra Health CurrentSince Oct 7, 2020 Accepting new patients
Cooperstown Medical Center CurrentSince Aug 1, 2024 Accepting new patients
Cooperstown Medical Center CurrentSince Aug 1, 2024 Accepting new patients

Locations

107 12th St S
Cooperstown, ND 58425
Phone (701) 786-1700

1200 Roberts Ave NE
Cooperstown, ND 58425
Phone (701) 797-2128

212 S 4th St
Ste 200
Grand Forks, ND 58201
Phone (701) 757-2100

212 S 4th St
Ste 301
Grand Forks, ND 58201
Phone (701) 757-2100

607 Towner Ave
Larimore, ND 58251
Phone (701) 318-9399

Organizations & group practices 5

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": "1600646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600646400000",
    "number": "1982210308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 S 4TH ST STE 301",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582014776",
            "telephone_number": "701-757-2100",
            "fax_number": "701-757-0305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 S 4TH ST STE 301",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582014776",
            "telephone_number": "701-757-2100",
            "fax_number": "701-757-0305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "KRISTEN",
        "middle_name": "MARIE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-21",
        "last_updated": "2020-09-21",
        "certification_date": "2020-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ND",
            "license": "R33316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Forks, ND

Sources for this page

Verify at the official NPI Registry.