MACKENZIE SNORTUM (PMHNP) – Psychiatric/Mental Health Nurse Practitioner, NPI 1013555887
Psychiatric/Mental Health Nurse Practitioner
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Profile Insights
NPPES metrics only — not quality of care.
5,720 NURSE PRACTITIONER in MN
Provider Addresses for MACKENZIE SNORTUM (PMHNP)
200 W Walnut Ave
Upsala, MN 563842305
Phone: (320) 573-4600
Type: Location
18846 Eagle Bend Rd
Park Rapids, MN 564702073
Phone: (218) 732-3721
Type: Location
1005 Wells Ave W
Sebeka, MN 564772692
Phone: (218) 837-6406
Type: Location
105 Spruce St NW
Remer, MN 566724301
Phone: (218) 670-2310
Type: Location
1104 4th Ave NE
Long Prairie, MN 563470008
Phone: (320) 732-2360
Type: Location
824 N 11TH ST
MONTEVIDEO, MN 562651629
Phone: (320) 269-8877
Fax: (320) 269-8186
Type: Mailing
3970 180TH ST
MONTEVIDEO, MN 562654415
Phone: (320) 321-9599
Type: Mailing
3970 180th St
Montevideo, MN 562654415
Phone: (320) 321-9599
Type: Location
20122 239TH AVE
NEVIS, MN 564674209
Phone: (320) 321-9599
Fax: (877) 962-3624
Type: Mailing
1011 1ST ST E STE 5
PARK RAPIDS, MN 564701764
Phone: (320) 321-9599
Fax: (877) 962-3624
Type: Location
260 Magnus Johnson St N
Kimball, MN 553532794
Phone: (320) 398-8646
Type: Location
840 2nd St NW
Aitkin, MN 564311158
Phone: (218) 927-2164
Type: Location
850 2nd St NW
Aitkin, MN 564311140
Phone: (218) 927-2164
Type: Location
215 Tousley Ave S
New York Mills, MN 565674400
Phone: (218) 385-4700
Type: Location
1319 GROVE AVE
MONTEVIDEO, MN 562651725
Phone: (320) 321-9599
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2020-01-15
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20200115001854 | I | Nurse Practitioner | MN | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 56384)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | ND | |
| Nurse Practitioner | MN |
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