Active NPI
Garnet Aanenson
- Private Vehicle
- McIntosh, MN
National Provider Identifier
1124100326
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Private Vehicle
- License
- H748001536619
- Practice address
- 430 State Street NW
McIntosh, MN 56556-0247 - Phone
- (218) 563-2753
- NPI assigned
- Oct 19, 2006
- 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 |
|---|---|---|---|---|
| Private Vehicle | 347C00000X | H748001536619 | MN | Primary |
Addresses
Primary practice location
430 State Street NW
McIntosh, MN 56556-0247
Mailing address
430 State Street NW
McIntosh, MN 56556-0247
Phone (218) 563-2753
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 420M7MC | Other | MN | BLUE CROSS/BLUE SHIELD PL |
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 |
|---|---|---|---|
| H748001536619 | MN | MD | Private Vehicle |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1124100326",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "430 STATE STREET NW",
"city": "MCINTOSH",
"state": "MN",
"postal_code": "565560247",
"telephone_number": "218-563-2753"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "430 STATE STREET NW",
"city": "MCINTOSH",
"state": "MN",
"postal_code": "565560247",
"telephone_number": "218-563-2753"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AANENSON",
"first_name": "GARNET",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "347C00000X",
"taxonomy_group": "",
"desc": "Private Vehicle",
"state": "MN",
"license": "H748001536619",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS/BLUE SHIELD PL",
"identifier": "420M7MC",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in McIntosh, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.