Active NPI
Taylor Jean Rickers, B.S, LADC
- Counselor
- Bemidji, MN
National Provider Identifier
1215543533
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 305795
- Practice address
- 116 3Rd St NW
Bemidji, MN 56601-3102 - Phone
- (218) 556-8753
- NPI assigned
- Sep 22, 2020
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | 305795 | MN | Primary |
Addresses
Primary practice location
116 3Rd St NW
Bemidji, MN 56601-3102
Mailing address
PO Box 5074
Sioux Falls, SD 57117-5074
Phone (605) 328-6585
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
- Credentials
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 305795 | MN | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sanford Health of Northern Minnesota | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Internal Medicine Physician
- Bemidji, MN
- NPI 1780628149
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1600732800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649894400000",
"number": "1215543533",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5074",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "571175074",
"telephone_number": "605-328-6585",
"fax_number": "605-328-6512"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "116 3RD ST NW",
"city": "BEMIDJI",
"state": "MN",
"postal_code": "566013102",
"telephone_number": "218-556-8753"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICKERS",
"first_name": "TAYLOR",
"middle_name": "JEAN",
"credential": "B.S, LADC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-09-22",
"last_updated": "2022-04-14",
"certification_date": "2022-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "MN",
"license": "305795",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bemidji, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.