Organization Active NPI

Herself Health MN Membership PC

  • Internal Medicine Physician
  • Saint Paul, MN
National Provider Identifier
1114887221
Registry record updated Nov 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
HERSELF HEALTH MN MEMBERSHIP PC
Practice address
2004 Ford Pkwy
Saint Paul, MN 55116-1931
Phone
(888) 290-1209
NPI assigned
Nov 12, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2025

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

Authorized official

Name
Deborah Dittberner, MD
Title
Owner/President
Phone
(888) 290-1209

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

2004 Ford Pkwy
Saint Paul, MN 55116-1931

Mailing address

2004 Ford Pkwy
Saint Paul, MN 55116-1931
Phone (888) 290-1209

Other names 1

  • Herself Health Other name

National Provider Directory

National Provider Directory

Locations

2004 Ford Pkwy
Saint Paul, MN 55116
Phone (612) 256-8225

NPI Registry JSON

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

{
    "created_epoch": "1762905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762905600000",
    "number": "1114887221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2004 FORD PKWY",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551161931",
            "telephone_number": "888-290-1209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2004 FORD PKWY",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551161931",
            "telephone_number": "888-290-1209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERSELF HEALTH MN MEMBERSHIP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-12",
        "last_updated": "2025-11-12",
        "certification_date": "2025-11-12",
        "status": "A",
        "authorized_official_last_name": "DITTBERNER",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "888-290-1209",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Herself Health",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.