Emmanuel Randolph Wheagar

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

6248 Lakeland Ave N
Brooklyn Park, MN 55428-2986

Phone

(848) 230-1286

NPI assigned

Feb 13, 2020

Last updated

Feb 13, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Esteem Home Health Services

  dba Esteem Care Systems

  • Assisted Living Facility
  • Brooklyn Center, MN
  • NPI 1104450840
  NPD Authorized official

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

{
    "created_epoch": "1581552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581552000000",
    "number": "1235762667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6248 LAKELAND AVE N STE 208",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554282989",
            "telephone_number": "848-230-1286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6248 LAKELAND AVE N",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554282986",
            "telephone_number": "848-230-1286"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6248 LAKELAND AVE N SUITE 208 MINNEAPOLIS, MN SUITE 208",
            "address_purpose": "LOCATION",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "55428",
            "country_code": "US",
            "telephone_number": "848-203-1286",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHEAGAR",
        "first_name": "EMMANUEL",
        "middle_name": "RANDOLPH",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-13",
        "last_updated": "2020-02-13",
        "certification_date": "2020-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVER'S LICENSE",
            "identifier": "W32792257902702",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Case Manager/Care Coordinator in Brooklyn Park, MN
• Providers in Brooklyn Park, MN by specialty
• Case Manager/Care Coordinator in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2020; 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.