Individual provider Active NPI

Elizabeth Ann Ankeny, FNP-C

  • Family Nurse Practitioner
  • Glenwood, MN
National Provider Identifier
1154345759
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R164260-3 Issued in MN
Practice address
10 4TH Ave SE
Glenwood, MN 56334-1820
Phone
(320) 634-4521
Fax
(320) 634-2262
NPI assigned
Jul 27, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 R164260-3 MN Primary

Addresses

Primary practice location

10 4TH Ave SE
Glenwood, MN 56334-1820

Mailing address

10 4TH Ave SE
Glenwood, MN 56334-1820
Phone (320) 634-4521

Other identifiers 8

IdentifierTypeStateIssuer
01-21693OtherMEDICA
01-21698OtherMEDICA CHOICE/SELECT
394G7ANOtherMNBLUE CROSS
2237466OtherARAZ
NA9331042389OtherPREFERRED ONE
01-21697OtherMEDICA
01-21699OtherMEDICA
132439OtherUCARE

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
I20041124000604 MN Practitioner - Nurse Practitioner 0042275422 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Glacial Ridge Hospital DistrictGroup PAC ID 5294789194, 69 clinicians

Practice addresses (Care Compare)

417 Franklin St S
Glenwood, MN 56334-1518
Phone (320) 634-5157

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R164260-3MNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Glacial Ridge Hospital District CurrentSince Sep 15, 2005 Accepting new patients
Glacial Ridge Hospital District CurrentSince Sep 15, 2005 Accepting new patients
Glacial Ridge Hospital District CurrentSince Sep 15, 2005 Accepting new patients
Kensington Medical Center Past Accepting new patients
Glacial Ridge Hospital District Past Accepting new patients
Affiliated Community Medical Centers, LTD Past Accepting new patients

Locations

111 Pleasant Ave N
Brooten, MN 56316
Phone (320) 346-2272

10 4th Ave SE
Glenwood, MN 56334
Phone (320) 634-5157

417 Franklin St S
Glenwood, MN 56334
Phone (320) 634-5157

19 Central Ave N
Kensington, MN 56343
Phone (320) 965-2690

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/glac-1755385c

Organizations & group practices 6

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154345759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 4TH AVE SE",
            "city": "GLENWOOD",
            "state": "MN",
            "postal_code": "563341820",
            "telephone_number": "320-634-4521",
            "fax_number": "320-634-2262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 4TH AVE SE",
            "city": "GLENWOOD",
            "state": "MN",
            "postal_code": "563341820",
            "telephone_number": "320-634-4521",
            "fax_number": "320-634-2262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANKENY",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "R164260-3",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "01-21693",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA CHOICE/SELECT",
            "identifier": "01-21698",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "394G7AN",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARAZ",
            "identifier": "2237466",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "NA9331042389",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "01-21697",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "01-21699",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "132439",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenwood, MN

Sources for this page

Verify at the official NPI Registry.