Active NPI
Shilpa Mikkilineni, M.D.
- Psychiatry Physician
- Coon Rapids, MN
National Provider Identifier
1255508610
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 54841
- Practice address
- 9055 Springbrook Dr NW
Coon Rapids, MN 55433-5841 - Phone
- (763) 780-9155
- NPI assigned
- May 14, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 54841 | MN | Primary |
Addresses
Primary practice location
9055 Springbrook Dr NW
Coon Rapids, MN 55433-5841
Mailing address
9055 Springbrook Dr NW
Coon Rapids, MN 55433-5841
Phone (763) 780-9155
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 54841 | MN | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210723200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1353456000000",
"number": "1255508610",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9055 SPRINGBROOK DR NW",
"city": "COON RAPIDS",
"state": "MN",
"postal_code": "554335841",
"telephone_number": "763-780-9155"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9055 SPRINGBROOK DR NW",
"city": "COON RAPIDS",
"state": "MN",
"postal_code": "554335841",
"telephone_number": "763-780-9155"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIKKILINENI",
"first_name": "SHILPA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-05-14",
"last_updated": "2012-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MN",
"license": "54841",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coon Rapids, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.