Individual provider Active NPI

Anna Rauch, APRN, CNP, PNP-PC

  • Pediatric Nurse Practitioner
  • Saint Paul, MN
National Provider Identifier
1184236739
Registry record updated Aug 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
7246 Issued in MN
Practice address
200 University Ave E
Saint Paul, MN 55101-2507
Phone
(651) 290-8707
NPI assigned
Aug 17, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 7246 MN Primary

Addresses

Primary practice location

200 University Ave E
Saint Paul, MN 55101-2507

Mailing address

1939 Bielenberg Dr
Woodbury, MN 55125-1524
Phone (651) 331-0735

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
I20200901000628 MN Practitioner - Nurse Practitioner 5294152526 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7246MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Gillette Children'S Specialty Healthcare CurrentSince Sep 21, 2020 Accepting new patients
Gillette Children'S Specialty Healthcare CurrentSince Sep 21, 2020 Accepting new patients
Gillette Children'S Specialty Healthcare Past Accepting new patients

Locations

305 E Nicollet Blvd
Ste 200
Burnsville, MN 55337
Phone (952) 223-3400

9550 Upland Ln N
Ste 220
Maple Grove, MN 55369
Phone (612) 902-8595

200 University Ave E
Saint Paul, MN 55101
Phone (651) 291-2848

Organizations & group practices 3

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": "1597622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597622400000",
    "number": "1184236739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1939 BIELENBERG DR",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551251524",
            "telephone_number": "651-331-0735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 UNIVERSITY AVE E",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551012507",
            "telephone_number": "651-290-8707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAUCH",
        "first_name": "ANNA",
        "name_prefix": "Mrs.",
        "credential": "APRN, CNP, PNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-17",
        "last_updated": "2020-08-17",
        "certification_date": "2020-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MN",
            "license": "7246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.