Active NPI
Gershom Aaron Tam, NP
- Critical Care Neonatal Nurse Practitioner
- Minneapolis, MN
National Provider Identifier
1255930202
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Critical Care Neonatal Nurse Practitioner
- License
- 7824
- Practice address
- 2525 Chicago Ave
Minneapolis, MN 55404-4518 - Phone
- (612) 813-6000
- NPI assigned
- Oct 21, 2020
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Critical Care Neonatal Nurse Practitioner | 363LN0005X | 7824 | MN | Primary |
Addresses
Primary practice location
2525 Chicago Ave
Minneapolis, MN 55404-4518
Mailing address
2525 Chicago Ave
Minneapolis, MN 55404-4518
Phone (408) 505-7005
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
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7824 | MN | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1603238400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603238400000",
"number": "1255930202",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2525 CHICAGO AVE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554044518",
"telephone_number": "408-505-7005"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2525 CHICAGO AVE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554044518",
"telephone_number": "612-813-6000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAM",
"first_name": "GERSHOM",
"middle_name": "AARON",
"name_prefix": "Mr.",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-10-21",
"last_updated": "2020-10-21",
"certification_date": "2020-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "363LN0005X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Neonatal, Critical Care",
"state": "MN",
"license": "7824",
"primary": true
}
],
"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 Oct 21, 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.