Active NPI
Nice Healthcare PLLC
- Family Nurse Practitioner
- Roseville, MN
National Provider Identifier
1073071239
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- Legal business name
- NICE HEALTHCARE PLLC
- Practice address
- 2786 Fairview Ave N
Roseville, MN 55113-1306 - Phone
- (651) 334-0720
- NPI assigned
- Mar 6, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Thompson Temilade Aderinkomi
- Title
- Ceo
- Phone
- (651) 334-0720
Specialties & licenses 8
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Professional Counselor | 101YP2500X | |||
| Clinical Psychologist | 103TC0700X | |||
| Social Worker | 104100000X | |||
| Clinical Social Worker | 1041C0700X | |||
| Marriage & Family Therapist | 106H00000X | |||
| Medical Physician Assistant | 363AM0700X | |||
| Family Nurse Practitioner | 363LF0000X | Primary |
Addresses
Primary practice location
2786 Fairview Ave N
Roseville, MN 55113-1306
Mailing address
2786 Fairview Ave N
Roseville, MN 55113-1306
Phone (651) 334-0720
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 24D2134358 | Nice Healthcare, LLC | Certificate of waiver | Jul 31, 2027 |
National Provider Directory
National Provider DirectoryLocations
2786 Fairview Ave N
Roseville, MN 55113
Phone (651) 283-7363
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Nurse Practitioner
- Moose Lake, MN
- NPI 1679836340
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1551830400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1730419200000",
"number": "1073071239",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2786 FAIRVIEW AVE N",
"city": "ROSEVILLE",
"state": "MN",
"postal_code": "551131306",
"telephone_number": "651-334-0720"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2786 FAIRVIEW AVE N",
"city": "ROSEVILLE",
"state": "MN",
"postal_code": "551131306",
"telephone_number": "651-334-0720"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NICE HEALTHCARE PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2019-03-06",
"last_updated": "2024-11-01",
"certification_date": "2024-11-01",
"status": "A",
"authorized_official_last_name": "ADERINKOMI",
"authorized_official_first_name": "THOMPSON",
"authorized_official_middle_name": "TEMILADE",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "651-334-0720"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Professional",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist, Clinical",
"state": null,
"license": null,
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Marriage & Family Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physician Assistant, Medical",
"state": null,
"license": null,
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Family",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Roseville, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.