Organization Active NPI

A Chance to Grow, Inc.

  • Home Health Agency
  • Minneapolis, MN
National Provider Identifier
1104918143
Registry record updated Aug 26, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
HFID-02476 A Issued in MN
Legal business name
A CHANCE TO GROW, INC.
Practice address
1800 2ND St NE
Minneapolis, MN 55418-4306
Phone
(612) 789-1236
Fax
(612) 706-5555
NPI assigned
Sep 28, 2006
Last updated
Aug 26, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2009

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

Authorized official

Name
Erica Jean Dickerson, MA, CCC/SLP
Title
Director of Clinical & Home Based
Phone
(612) 789-1236

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X HFID-02476 A MN Primary
Optometrist 152W00000X 2605 MN
Vision Therapy Optometrist 152WV0400X 2605 MN

Addresses

Primary practice location

1800 2ND St NE
Minneapolis, MN 55418-4306

Mailing address

1800 2ND St NE
Minneapolis, MN 55418-4306
Phone (612) 789-1236

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090605000134 MN Part B Supplier - Clinic/Group Practice 8628128022 Receives reassigned benefits from 1 practitioner
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Minneapolis, MN

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251244800000",
    "number": "1104918143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 2ND ST NE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554184306",
            "telephone_number": "612-789-1236",
            "fax_number": "612-706-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 2ND ST NE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554184306",
            "telephone_number": "612-789-1236",
            "fax_number": "612-706-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A CHANCE TO GROW, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2009-08-26",
        "status": "A",
        "authorized_official_last_name": "DICKERSON",
        "authorized_official_first_name": "ERICA",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "DIRECTOR OF CLINICAL & HOME BASED",
        "authorized_official_telephone_number": "612-789-1236",
        "authorized_official_credential": "MA, CCC/SLP"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MN",
            "license": "HFID-02476 A",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "2605",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "MN",
            "license": "2605",
            "primary": false
        }
    ],
    "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 Aug 26, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.