Active NPI
Mark Rollins Bixby, M.D.
- Family Medicine Physician
- Minneapolis, MN
National Provider Identifier
1093751323
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 24754
- Practice address
- 2600 39TH Ave NE
Minneapolis, MN 55421-4379 - Phone
- (612) 706-2900
- Fax
- (612) 706-2901
- NPI assigned
- Jun 22, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 24754 | MN | Primary |
Addresses
Primary practice location
2600 39TH Ave NE
Minneapolis, MN 55421-4379
Mailing address
8301 Golden Valley Road, Suite 300
North Memorial Health Care - Clinic Services
Golden Valley, MN 55427-4484
Phone (763) 581-0908
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| OD081BI | Other | MN | BCBS |
| 1000070 | Other | MN | PREFERRED ONE |
| 01-22161 | Other | MN | MEDICA CHOICE & PRIMARY |
| 102681 | Other | MN | UCARE |
| 21797 | Other | MN | ARAZ |
| 524377700 | Medicaid | MN | |
| HP27055 | Other | MN | HEALTHPARTNERS |
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)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1282867200000",
"number": "1093751323",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8301 GOLDEN VALLEY ROAD, SUITE 300",
"address_2": "NORTH MEMORIAL HEALTH CARE - CLINIC SERVICES",
"city": "GOLDEN VALLEY",
"state": "MN",
"postal_code": "554274484",
"telephone_number": "763-581-0908",
"fax_number": "952-767-2380"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2600 39TH AVE NE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554214379",
"telephone_number": "612-706-2900",
"fax_number": "612-706-2901"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BIXBY",
"first_name": "MARK",
"middle_name": "ROLLINS",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-22",
"last_updated": "2010-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MN",
"license": "24754",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "OD081BI",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED ONE",
"identifier": "1000070",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA CHOICE & PRIMARY",
"identifier": "01-22161",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UCARE",
"identifier": "102681",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ARAZ",
"identifier": "21797",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "524377700",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHPARTNERS",
"identifier": "HP27055",
"state": "MN"
}
],
"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 Aug 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.