Active NPI
John Andrew Ennen
- Health Educator
- St Anthony, MN
National Provider Identifier
1164120267
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health Educator
- Practice address
- 2500 Pahl Ave
St Anthony, MN 55418-3146 - Phone
- (651) 295-6675
- NPI assigned
- Feb 17, 2023
- Last updated
- Feb 17, 2023
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Health Educator | 174H00000X | Primary |
Addresses
Primary practice location
2500 Pahl Ave
St Anthony, MN 55418-3146
Mailing address
2500 Pahl Ave
St Anthony, MN 55418-3146
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1676592000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1676592000000",
"number": "1164120267",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2500 PAHL AVE",
"city": "ST ANTHONY",
"state": "MN",
"postal_code": "554183146"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2500 PAHL AVE",
"city": "ST ANTHONY",
"state": "MN",
"postal_code": "554183146",
"telephone_number": "651-295-6675"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ENNEN",
"first_name": "JOHN",
"middle_name": "ANDREW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-02-17",
"last_updated": "2023-02-17",
"certification_date": "2023-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "174H00000X",
"taxonomy_group": "",
"desc": "Health Educator",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St Anthony, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.