Individual provider Active NPI

Povi Dzodzoe Folivi, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Saint Paul, MN
National Provider Identifier
1124788765
Registry record updated Aug 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
8511 Issued in MN
Practice address
317 York Ave
Saint Paul, MN 55130-4039
Phone
(651) 774-0011
Fax
(651) 774-0606
NPI assigned
Dec 22, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 8511 MN Primary

Addresses

Primary practice location

317 York Ave
Saint Paul, MN 55130-4039

Mailing address

5005 142ND Path W
Apple Valley, MN 55124-7708
Phone (612) 703-3498

Other practice location 1

5005 142nd Path W
Apple Valley, MN 55124-7708
Phone (612) 703-3498

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL N/A Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220603001183 MN Practitioner - Nurse Practitioner 2264810282 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
People IncorporatedGroup PAC ID 7012043540, 31 clinicians

Practice addresses (Care Compare)

1930 Coon Rapids Blvd NW
Coon Rapids, MN 55433-4708
Phone (651) 774-0011

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8511MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
People Incorporated CurrentSince Mar 7, 2022 Accepting new patients
People Incorporated Current Accepting new patients

Locations

2120 Park Ave
Minneapolis, MN 55404
Phone (612) 872-2000

1930 Coon Rapids Blvd NW
Minneapolis, MN 55433
Phone (763) 427-7964

5555 Boone Ave N
New Hope, MN 55428
Phone (763) 331-3033

3000 Ames Crossing Rd
Ste 600
Saint Paul, MN 55121
Phone (651) 288-3467

317 York Ave
Saint Paul, MN 55130
Phone (651) 771-0286

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1640131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692835200000",
    "number": "1124788765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5005 142ND PATH W",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551247708",
            "telephone_number": "612-703-3498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 YORK AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551304039",
            "telephone_number": "651-774-0011",
            "fax_number": "651-774-0606"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5005 142nd Path W",
            "address_purpose": "LOCATION",
            "city": "Apple Valley",
            "state": "MN",
            "postal_code": "551247708",
            "country_code": "US",
            "telephone_number": "612-703-3498",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOLIVI",
        "first_name": "POVI",
        "middle_name": "DZODZOE",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-22",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "8511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "N/A",
            "affiliation": "N",
            "endpointDescription": "N/A",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "N/a",
            "address_1": "5005 142nd Path W",
            "city": "Apple Valley",
            "state": "MN",
            "country_code": "US",
            "postal_code": "551247708",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.