Individual provider Active NPI

Anne Bushnell, LICSW

  • Clinical Social Worker
  • Eagan, MN
National Provider Identifier
1043745078
Registry record updated May 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
19734 Issued in MN
Practice address
3460 Washington Dr Ste 200
Eagan, MN 55122
Phone
(651) 232-3339
NPI assigned
Apr 27, 2017
Last updated
May 24, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 19734 MN Primary

Addresses

Primary practice location

3460 Washington Dr Ste 200
Eagan, MN 55122

Mailing address

3460 Washington Dr Ste 200
Eagan, MN 55122-4302

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
I20180514001281 MN Practitioner - Clinical Social Worker 2163786401 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bhsi LLCGroup PAC ID 3274504816, 33 clinicians

Practice addresses (Care Compare)

3460 Washington Dr
Suite 200
Eagan, MN 55122-4302
Phone (651) 769-6200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19734MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Bhsi, LLC CurrentSince Apr 16, 2018 Accepting new patients

Locations

3460 Washington Dr
Ste 200
Eagan, MN 55122
Phone (651) 232-3339

2497 7th Ave E
Ste 101
Saint Paul, MN 55109
Phone (651) 769-6400

2497 7th Ave E
Saint Paul, MN 55109
Phone (651) 387-2165

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1493251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527120000000",
    "number": "1043745078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3460 WASHINGTON DR STE 200",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551224302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3460 WASHINGTON DR STE 200",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "55122",
            "telephone_number": "651-232-3339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSHNELL",
        "first_name": "ANNE",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-27",
        "last_updated": "2018-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "19734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagan, MN

Sources for this page

Verify at the official NPI Registry.