Individual provider Active NPI

Ernesto Agron

  • Family Nurse Practitioner
  • Minneapolis, MN
National Provider Identifier
1124277975
Registry record updated Nov 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209005414 Issued in IL
Practice address
920 2ND Ave S
Suite 400
Minneapolis, MN 55402-3318
Phone
(612) 225-1534
NPI assigned
Sep 17, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209005414 IL Primary

Addresses

Primary practice location

920 2ND Ave S
Suite 400
Minneapolis, MN 55402-3318

Mailing address

1342 W Grenshaw St Unit 1
Chicago, IL 60607-4805
Phone (312) 590-1601

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

NPI Registry JSON

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

{
    "created_epoch": "1221609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541721600000",
    "number": "1124277975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1342 W GRENSHAW ST UNIT 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606074805",
            "telephone_number": "312-590-1601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 2ND AVE S",
            "address_2": "SUITE 400",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554023318",
            "telephone_number": "612-225-1534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGRON",
        "first_name": "ERNESTO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-17",
        "last_updated": "2018-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209005414",
            "primary": true
        }
    ],
    "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 Nov 9, 2018; 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.