Active NPI
Martha Waterfield
- Student in an Organized Health Care Education/Training Program
- Eden Prairie, MN
National Provider Identifier
1043077639
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 7525 Mitchell Rd Ste 100
Eden Prairie, MN 55344-1900 - Phone
- (612) 924-1476
- Fax
- (952) 224-2284
- NPI assigned
- Mar 1, 2024
- 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
7525 Mitchell Rd Ste 100
Eden Prairie, MN 55344-1900
Mailing address
2219 Arthur St NE
Minneapolis, MN 55418-3910
Phone (612) 710-0060
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)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Innovations, Inc. | Current | Accepting new patients |
Locations
7525 Mitchell Rd
Ste 100
Eden Prairie, MN 55344
Phone (952) 224-2282
Organizations & group practices 1
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.
-
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- Anoka, MN
- NPI 1992862783
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1709251200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1709251200000",
"number": "1043077639",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2219 ARTHUR ST NE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554183910",
"telephone_number": "612-710-0060"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7525 MITCHELL RD STE 100",
"city": "EDEN PRAIRIE",
"state": "MN",
"postal_code": "553441900",
"telephone_number": "612-924-1476",
"fax_number": "952-224-2284"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATERFIELD",
"first_name": "MARTHA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-03-01",
"last_updated": "2024-03-01",
"certification_date": "2024-02-29",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eden Prairie, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.