Individual provider Active NPI

Nathan Foote, LICSW

  • Social Worker
  • Lake Elmo, MN
National Provider Identifier
1003213299
Registry record updated Oct 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
21133 Issued in MN
Practice address
8550 Hudson Blvd N
Lake Elmo, MN 55042-5500
Phone
(651) 254-8580
NPI assigned
Dec 3, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 21133 MN Primary

Addresses

Primary practice location

8550 Hudson Blvd N
Lake Elmo, MN 55042-5500

Mailing address

1100 Glenwood Ave
Minneapolis, MN 55405-1430
Phone (612) 871-1454

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171128000804 MN Practitioner - Clinical Social Worker 7719244805 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Group Health IncGroup PAC ID 1759293954, 1,627 clinicians

Practice addresses (Care Compare)

8550 Hudson Blvd N
Lake Elmo, MN 55042-5500
Phone (651) 254-8580

8600 Nicollet Ave
Bloomington, MN 55420-2824
Phone (952) 884-1148

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
21133MNMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Group Health, Inc. CurrentSince Jan 1, 2021 Accepting new patients
Group Health, Inc. CurrentSince Jan 1, 2021 Accepting new patients
Washburn Center for Children Past Accepting new patients

Locations

8550 Hudson Blvd N
Lake Elmo, MN 55042
Phone (651) 254-8580

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

Organizations & group practices 3

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": "1417564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730073600000",
    "number": "1003213299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 GLENWOOD AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554051430",
            "telephone_number": "612-871-1454",
            "fax_number": "612-871-1505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8550 HUDSON BLVD N",
            "city": "LAKE ELMO",
            "state": "MN",
            "postal_code": "550425500",
            "telephone_number": "651-254-8580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOOTE",
        "first_name": "NATHAN",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-12-03",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MN",
            "license": "21133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Elmo, MN

Sources for this page

Verify at the official NPI Registry.