Individual provider Active NPI

Adele Starr, NP

  • Adult Health Nurse Practitioner
  • Minneapolis, MN
National Provider Identifier
1154432110
Registry record updated Nov 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
R1103676 Issued in MN
Practice address
1313 Penn Ave N
Minneapolis, MN 55411-3047
Phone
(612) 543-2500
Fax
(612) 302-4780
NPI assigned
Aug 31, 2006
Last updated
Nov 7, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X R1103676 MN Primary

Addresses

Primary practice location

1313 Penn Ave N
Minneapolis, MN 55411-3047

Mailing address

1313 Penn Ave N
Minneapolis, MN 55411-3047
Phone (612) 543-2500

Other identifiers 1

IdentifierTypeStateIssuer
862342200MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R1103676MNMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hennepin County CurrentSince Dec 11, 2006 Accepting new patients
Hennepin County Current Accepting new patients
Hennepin County CurrentSince Dec 11, 2006 Accepting new patients
Ecc Addiction & Toxicology Services LLC Past Accepting new patients
Emergency Care Consultants, PA Past Accepting new patients

Locations

1313 Penn Ave N
Minneapolis, MN 55411
Phone (612) 302-4600

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352246400000",
    "number": "1154432110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1313 PENN AVE N",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554113047",
            "telephone_number": "612-543-2500",
            "fax_number": "612-302-4870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 PENN AVE N",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554113047",
            "telephone_number": "612-543-2500",
            "fax_number": "612-302-4780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARR",
        "first_name": "ADELE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2012-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MN",
            "license": "R1103676",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "862342200",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.