NPIMap

Organization Active NPI

Associated Nephrology Consultants, P.a.

  • Nephrology Physician
  • Maplewood, MN
National Provider Identifier
1104976158
Registry record updated Oct 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
ASSOCIATED NEPHROLOGY CONSULTANTS, P.A.
Practice address
1997 Sloan PL Ste 17
Maplewood, MN 55117-2051
Phone
(651) 772-6251
Fax
(651) 224-9661
NPI assigned
Jan 11, 2007
Last updated
Oct 25, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2022

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

Authorized official

Name
Shannon Elizabeth Doyle, MDNPI 1326005679
Title
Owner Ceo
Phone
(651) 772-6251

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X MN Primary

Addresses

Primary practice location

1997 Sloan PL Ste 17
Maplewood, MN 55117-2051

Mailing address

2854 Highway 55
Suite 130
Eagan, MN 55121-1447
Phone (651) 842-3378

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090827000310 MN Part B Supplier - Clinic/Group Practice 7214004068 Receives reassigned benefits from 19 practitioners
Practice locations: Hastings, MN; Maplewood, MN

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
24D1103593Associated Nephrology Consultants1997 Sloan Place Suite 17, Maplewood, MN 55117Provider-performed microscopyAug 14, 2027

National Provider Directory

National Provider Directory

Locations

1997 Sloan Pl
Ste 17
Saint Paul, MN 55117
Phone (651) 772-6251

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/3y297hHso-SAgtaVMIScpv67gSH7SYy3/

Practitioners & affiliated clinicians

Practitioners 20

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.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666656000000",
    "number": "1104976158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2854 HIGHWAY 55",
            "address_2": "SUITE 130",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551211447",
            "telephone_number": "651-842-3378",
            "fax_number": "651-224-5273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1997 SLOAN PL STE 17",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551172051",
            "telephone_number": "651-772-6251",
            "fax_number": "651-224-9661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSOCIATED NEPHROLOGY CONSULTANTS, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-11",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A",
        "authorized_official_last_name": "DOYLE",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "OWNER CEO",
        "authorized_official_telephone_number": "651-772-6251",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maplewood, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.