KALLIE JO WENNERBERG AGNP-C
NPI 1538893920
Nurse Practitioner in Fargo, ND

Q: What is Kallie Wennerberg's NPI number?

The NPI number for Kallie Wennerberg is 1538893920. It was assigned to this individual provider in the NPPES registry on July 12, 2022. The provider is also known as Kallie Jo Haugen.

Q: What is Kallie Wennerberg's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Kallie Wennerberg was last updated on February 3, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 12, 2022PECOS EnrolledAccepts Medicare Assignment

736 BROADWAY N, FARGO, ND 58102(701) 234-2000 Get Directions Write a Review

NPPES record last updated: February 3, 2023. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Feb 3, 2023, Jul 12, 2022 (2 updates tracked since 2022).

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About Kallie Jo Wennerberg Agnp-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KALLIE JO WENNERBERG AGNP-C (NPI 1538893920) is an individual nurse practitioner in Fargo, North Dakota, licensed in North Dakota (R43359) and active in the NPI registry since July 2022. She is enrolled in Medicare PECOS, is affiliated with Sanford Medical Center Fargo, and is a graduate of Other (2022).

NPPES Registry Identity

NPI1538893920

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameKALLIE JO WENNERBERGCredential: AGNP-C

Location Address736 BROADWAY NFargo, ND 58102-4421

Mailing AddressPo Box 5074Sioux Falls, SD 57117-5074

Phone(701) 234-2000

Sole ProprietorNo

Medical School CMSOtherGraduated 2022

Enumeration DateJuly 12, 2022

Last NPPES UpdateFebruary 3, 20232 updates tracked since enumeration

NPPES CertifiedFebruary 3, 2023

✔ NPI 1538893920 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in ND · R43359

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

736 BROADWAY N, Fargo, ND 58102

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Other Names 1

Former Name (1)Kallie Jo Haugen

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of North Dakota, Medica, Sanford Health Plan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kallie Jo Wennerberg Agnp-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9234503798

PECOS Enrollment IDI20230323001876

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Kallie Wennerberg reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Sanford Medical Center Fargo

2.7 mi

Occupational Medicine

3838 12TH AVE N
Fargo, ND 58102

Reassigned Medicare billing, North Dakota and Minnesota enrollments
Also billed through NPI 1184917924 (Minnesota)
1,464 clinicians in this Medicare group

NPI 1952323974 (701) 234-4700

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 8

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231

Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.

79 services47 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

57 services44 patients

Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes 99221

Initial hospital inpatient care refers to the first day of your stay in the hospital. This service typically includes a 30-minute check-up with a healthcare professional. They'll assess your health, discuss your condition, and plan your treatment. It's part of ensuring you receive the best possible care.

42 services42 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

42 services41 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

35 services26 patients

Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or G2212

This service refers to extended doctor visits where your healthcare provider spends additional time evaluating and managing your health beyond the primary procedure's required time. This includes each extra 15 minutes spent by the physician on the same day as the primary service.

22 services16 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Sanford Medical Center Fargo

Acute Care Hospitals · Fargo, ND

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number350011

Location801 Broadway NorthFargo, ND 58122 · Cass County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 58102 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$85.71 typical visit price

range $55.75 – $168.12

Typical copayment $21.42 (range $13.93 – $42.03)

Most-billed visit code 99203

Established Patient

$98.29 typical visit price

range $18.11 – $137.65

Typical copayment $24.57 (range $4.52 – $34.41)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. HASSAN BIN ATTIQUE M.D.

Internal Medicine (Nephrology)