Individual provider Active NPI

Cynthia J Brady, DNP

  • Pediatric Nurse Practitioner
  • Minneapolis, MN
National Provider Identifier
1184625931
Registry record updated Oct 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
R1081251 Issued in MN
Practice address
2530 Chicago Ave
Suite 400
Minneapolis, MN 55404-4387
Phone
(612) 813-3300
Fax
(612) 813-3349
NPI assigned
Aug 2, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2022

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 R1081251 MN Primary

Addresses

Primary practice location

2530 Chicago Ave
Suite 400
Minneapolis, MN 55404-4387

Mailing address

2530 Chicago Ave
Suite 400
Minneapolis, MN 55404-4387
Phone (612) 813-3300

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
I20110409000041 MN Practitioner - Nurse Practitioner 9931383353 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R1081251MNMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gillette Children'S Specialty Healthcare CurrentSince Feb 1, 2014 Accepting new patients
Children'S Respiratory & Critical Care Specialists. P.a. CurrentSince Nov 8, 2010 Accepting new patients
Gillette Children'S Specialty Healthcare CurrentSince Feb 1, 2014 Accepting new patients
Gillette Children'S Specialty Healthcare PastSince Nov 8, 2010 Accepting new patients

Locations

2530 Chicago Ave
Ste 400
Minneapolis, MN 55404
Phone (612) 813-3300

310 Smith Ave N
Ste 460
Saint Paul, MN 55102
Phone (651) 220-7000

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

Organizations & group practices 4

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": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664755200000",
    "number": "1184625931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2530 CHICAGO AVE",
            "address_2": "SUITE 400",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554044387",
            "telephone_number": "612-813-3300",
            "fax_number": "612-813-3349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2530 CHICAGO AVE",
            "address_2": "SUITE 400",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554044387",
            "telephone_number": "612-813-3300",
            "fax_number": "612-813-3349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADY",
        "first_name": "CYNTHIA",
        "middle_name": "J",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-02",
        "last_updated": "2022-10-03",
        "certification_date": "2022-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MN",
            "license": "R1081251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.