Active NPI
Carina Kanku
- Registered Nurse
- Minneapolis, MN
National Provider Identifier
1093227746
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- R200041-9
- Practice address
- 1421 Park Ave Ste 104
Minneapolis, MN 55404-1579 - Phone
- (612) 872-8811
- NPI assigned
- Nov 2, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | R200041-9 | MN | Primary |
Addresses
Primary practice location
1421 Park Ave Ste 104
Minneapolis, MN 55404-1579
Mailing address
PO Box 431172
Minneapolis, MN 55443-7267
Phone (612) 423-2115
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R200041-9 | MN | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Minnesota Quality Care, Inc. | Past | Accepting new patients |
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.
-
- Home Health Agency
- Minneapolis, MN
- NPI 1346444957
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1509580800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1509580800000",
"number": "1093227746",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 431172",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554437267",
"telephone_number": "612-423-2115"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1421 PARK AVE STE 104",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554041579",
"telephone_number": "612-872-8811"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KANKU",
"first_name": "CARINA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-11-02",
"last_updated": "2017-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MN",
"license": "R200041-9",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.