NPIMap

Individual provider Active NPI

Alicia Mercedes Reardon, APRN, CNP

  • Family Nurse Practitioner
  • Woodbury, MN
National Provider Identifier
1083205975
Registry record updated Feb 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
8000 Issued in MN
Practice address
2090 Woodwinds Dr Ste 200
Woodbury, MN 55125-2522
Phone
(651) 968-5201
Fax
(651) 968-5899
NPI assigned
Feb 2, 2021
Last updated
Feb 2, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 8000 MN Primary

Addresses

Primary practice location

2090 Woodwinds Dr Ste 200
Woodbury, MN 55125-2522

Mailing address

710 Commerce Dr Ste 200
Woodbury, MN 55125-4925
Phone (651) 968-5200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210209002638 MN Practitioner - Nurse Practitioner 3274948047 Reassigns benefits to 1 organization
I20210330002492 WI Practitioner - Nurse Practitioner 3274948047 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baldwin Area Medical Center IncGroup PAC ID 7911800586, 88 clinicians
Summit Orthopedics, LTDGroup PAC ID 8921900374, 282 clinicians

Practice addresses (Care Compare)

1100 Bergslien St
Baldwin, WI 54002-2600
Phone (715) 684-1555

2090 Woodwinds Dr
Woodbury, MN 55125-2522
Phone (651) 968-5201

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
8000MNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Baldwin Area Medical Center Inc. CurrentSince May 1, 2021 Accepting new patients
Summit Orthopedics, LTD. CurrentSince Feb 15, 2021 Accepting new patients
Baldwin Area Medical Center, Inc. CurrentSince May 1, 2021 Accepting new patients
Baldwin Area Medical Center, Inc. Current Accepting new patients
Summit Orthopedics LTD Current Accepting new patients
Ilbnc, P.a. Past Accepting new patients
Summit Orthopedics, LTD PastSince Feb 7, 2021 Accepting new patients

Locations

6050 Sycamore Ln N
Plymouth, MN 55442
Phone (651) 968-5462

1661 Saint Anthony Ave
Saint Paul, MN 55104
Phone (651) 968-5300

2620 Eagan Woods Dr
Saint Paul, MN 55121
Phone (651) 271-1592

2090 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 968-5801

2090 Woodwinds Dr
Ste 200
Woodbury, MN 55125
Phone (651) 968-5600

710 Commerce Dr
Ste 200
Woodbury, MN 55125
Phone (651) 968-5042

1100 Bergslien St
Baldwin, WI 54002
Phone (715) 684-1111

319 S Main St
River Falls, WI 54022
Phone (715) 425-6701

Interoperability endpoints

  • Direct secure messaging: aliciareardon@sol.allscriptsdirect.net
  • Direct secure messaging: areardon366790@excellian.direct.allina.com

Organizations & group practices 8

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.

Hospital & facility affiliations 20

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1612224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612224000000",
    "number": "1083205975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 COMMERCE DR STE 200",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551254925",
            "telephone_number": "651-968-5200",
            "fax_number": "651-730-3556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2090 WOODWINDS DR STE 200",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551252522",
            "telephone_number": "651-968-5201",
            "fax_number": "651-968-5899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REARDON",
        "first_name": "ALICIA",
        "middle_name": "MERCEDES",
        "credential": "APRN, CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-02",
        "last_updated": "2021-02-02",
        "certification_date": "2021-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "8000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, MN

Sources for this page

Verify at the official NPI Registry.