Individual provider Active NPI

Jane Kanan, LMFT

  • Marriage & Family Therapist
  • Minneapolis, MN
National Provider Identifier
1043778939
Registry record updated Mar 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
3653 Issued in MN
Practice address
1100 Glenwood Ave
Minneapolis, MN 55405-1430
Phone
(612) 871-1454
NPI assigned
Mar 9, 2019
Last updated
Mar 9, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 3653 MN Primary

Addresses

Primary practice location

1100 Glenwood Ave
Minneapolis, MN 55405-1430

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
I20231221001342 MN Practitioner - Marriage and Family Therapist 1254781982 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of ScottGroup PAC ID 4587605225, 11 clinicians

Practice addresses (Care Compare)

200 4TH Ave W
Shakopee, MN 55379-1220
Phone (952) 496-8481

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
County of Scott CurrentSince Jan 1, 2024 Accepting new patients
County of Scott CurrentSince Jan 1, 2024 Accepting new patients
Washburn Center for Children Past Accepting new patients
County of Scott Past Accepting new patients

Locations

200 4th Ave W
Shakopee, MN 55379
Phone (952) 496-8481

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, 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": "1552089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552089600000",
    "number": "1043778939",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 GLENWOOD AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554051430",
            "telephone_number": "612-871-1454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANAN",
        "first_name": "JANE",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-09",
        "last_updated": "2019-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "3653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.