Active NPI
Nancy Entgelmeier, CPNP
- Pediatric Nurse Practitioner
- St Paul, MN
National Provider Identifier
1013976554
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- R0938017
- Practice address
- 347 N Smith Ave
Childrens Specialty Clinic Feeding Clinic STPL MPLS
St Paul, MN 55102 - Phone
- (651) 220-6446
- NPI assigned
- Mar 22, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | R0938017 | MN | Primary |
Addresses
Primary practice location
347 N Smith Ave
Childrens Specialty Clinic Feeding Clinic STPL MPLS
St Paul, MN 55102
Mailing address
2910 Centre Pointe Dr 35-121a
Childrens Health Care
Roseville, MN 55113
Phone (651) 855-2327
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 400815400 | Medicaid | MN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Pediatric Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R0938017 | MN | MD | Pediatric Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142985600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1351555200000",
"number": "1013976554",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2910 CENTRE POINTE DR 35-121A",
"address_2": "CHILDRENS HEALTH CARE",
"city": "ROSEVILLE",
"state": "MN",
"postal_code": "55113",
"telephone_number": "651-855-2327",
"fax_number": "651-855-2310"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "347 N SMITH AVE",
"address_2": "CHILDRENS SPECIALTY CLINIC FEEDING CLINIC STPL MPLS",
"city": "ST PAUL",
"state": "MN",
"postal_code": "55102",
"telephone_number": "651-220-6446"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ENTGELMEIER",
"first_name": "NANCY",
"credential": "CPNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-22",
"last_updated": "2012-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "MN",
"license": "R0938017",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "400815400",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in St Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.