Kristin Cole Sorensen-Tanenbaum, NP-C

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

5112 Issued in MN

Practice address

413 SE 13TH St
Grand Rapids, MN 55744-0015

Phone

(218) 999-9908

NPI assigned

Jul 21, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Kristin Mary Sorensen-Tanenbaum Other name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner

State licenses

Practice roles

Locations

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.

• North Homes, Inc

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Grand Rapids, MN
  • NPI 1790826550
  Medicare reassignment NPD
• SMDC Medical Center

  • Adolescent and Children Mental Health Clinic/Center
  • Duluth, MN
  • NPI 1235488438
  Medicare reassignment NPD
• The Duluth Clinic LTD

  • Multi-Specialty Clinic/Center
  • Cloquet, MN
  • NPI 1902563638
  Medicare reassignment NPD
• The Duluth Clinic LTD

  • Multi-Specialty Clinic/Center
  • Duluth, MN
  • NPI 1245855162
  NPD
• The Duluth Clinic, LTD.

  • Community/Retail Pharmacy
  • Hinckley, MN
  • NPI 1245081066
  NPD
• SMDC Medical Center

  • General Acute Care Hospital
  • Duluth, MN
  • NPI 1033153895
  NPD (past)
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)
• House of the Good Shepherd Corporation

  • Local Education Agency (LEA)
  • Baltimore, MD
  • NPI 1942570353
  NPD (past)
• The House of the Good Shepherd of the City of Baltimore

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Baltimore, MD
  • NPI 1508980251
  NPD (past)

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

{
    "created_epoch": "1216598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601251200000",
    "number": "1992960819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3125 WILLIVAN WOODS",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557448661",
            "telephone_number": "301-741-6101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 SE 13TH ST",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557440015",
            "telephone_number": "218-999-9908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SORENSEN-TANENBAUM",
        "first_name": "KRISTIN",
        "middle_name": "COLE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-21",
        "last_updated": "2020-09-28",
        "certification_date": "2020-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "5112",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R160645",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R160645",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "SORENSEN-TANENBAUM",
            "middle_name": "MARY",
            "credential": "FNP-C, PMH-NP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Eric Soderberg, DC
• Solid Foundations of MN Inc
• Shelly M Soltis, DO
• Sonder Chiropractic, P.a.
• Jay Sonder, D.C.
• Daniel William Soular, MD
• Speak Easy LLC
• James Raymond Spenningsby, MD
• Abby Sperr, OD
• St Croix Hospice LLC

• Psychiatric/Mental Health Nurse Practitioner in Grand Rapids, MN
• Providers in Grand Rapids, MN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2020; 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.

Verify at the official NPI Registry.