Organization Active NPI

Axis Home Pca Agency Inc

  • Home Health Agency
  • Minneapolis, MN
National Provider Identifier
1205589272
Registry record updated Nov 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
AXIS HOME PCA AGENCY INC
Practice address
2417 Fremont Ave S
Minneapolis, MN 55405-2648
Phone
(612) 354-7714
NPI assigned
Jan 31, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2025

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

Authorized official

Name
Cubtan NurNPI 1548701105
Title
Owner
Phone
(612) 354-7714

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary
Nursing Care Agency 251J00000X

Addresses

Primary practice location

2417 Fremont Ave S
Minneapolis, MN 55405-2648

Mailing address

2417 Fremont Ave S
Minneapolis, MN 55405-2648
Phone (612) 354-7714

National Provider Directory

National Provider Directory
Tax ID family
Axis Home Pca Agency Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3807 Chicago Ave
Minneapolis, MN 55407

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1643587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762905600000",
    "number": "1205589272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2417 FREMONT AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554052648",
            "telephone_number": "612-354-7714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2417 FREMONT AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554052648",
            "telephone_number": "612-354-7714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AXIS HOME PCA AGENCY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-31",
        "last_updated": "2025-11-12",
        "certification_date": "2025-11-12",
        "status": "A",
        "authorized_official_last_name": "NUR",
        "authorized_official_first_name": "CUBTAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-354-7714"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.