Individual provider Active NPI

Anne Hawkins

  • Pediatric Nurse Practitioner
  • Minneapolis, MN
National Provider Identifier
1003109653
Registry record updated May 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
2016128 Issued in MN
Practice address
2530 Chicago Ave
CSC 390
Minneapolis, MN 55404-4289
Phone
(612) 813-6102
NPI assigned
May 16, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 2016128 MN Primary

Addresses

Primary practice location

2530 Chicago Ave
CSC 390
Minneapolis, MN 55404-4289

Mailing address

5712 14TH Ave S
Minneapolis, MN 55417-2535
Phone (612) 799-4143

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
I20110726000577 MN Practitioner - Nurse Practitioner 7618145285 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2016128MNMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Health Care CurrentSince Nov 1, 2015 Accepting new patients
Childrens Health Care CurrentSince Nov 1, 2015 Accepting new patients
Childrens Health Care Current Accepting new patients
Childrens Health Care Past Accepting new patients

Locations

2530 Chicago Ave
Minneapolis, MN 55404
Phone (612) 813-6000

2530 Chicago Ave
#390
Minneapolis, MN 55404
Phone (612) 813-6102

2525 Chicago Ave
Minneapolis, MN 55404
Phone (612) 813-6000

5901 Lincoln Dr
#2
Saint Louis Park, MN 55436
Phone (952) 992-5691

345 Smith Ave N
Saint Paul, MN 55102
Phone (651) 220-6000

347 Smith Ave N
Saint Paul, MN 55102
Phone (651) 220-6000

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/ya_22VheLN-3mn5hR1J6QJ0Z8rMCHJ7F/

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1305504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431820800000",
    "number": "1003109653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5712 14TH AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554172535",
            "telephone_number": "612-799-4143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2530 CHICAGO AVE",
            "address_2": "CSC 390",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554044289",
            "telephone_number": "612-813-6102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAWKINS",
        "first_name": "ANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-16",
        "last_updated": "2015-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MN",
            "license": "2016128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.