Active NPI
Molly Augustine
- Athletic Trainer
- Oak Park Heights, MN
National Provider Identifier
1275946394
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 2193
- Practice address
- 5803 Neal Ave N
Oak Park Heights, MN 55082-2177 - Phone
- (651) 351-2653
- NPI assigned
- Jun 5, 2014
- 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 2193 | MN | Primary |
Addresses
Primary practice location
5803 Neal Ave N
Oak Park Heights, MN 55082-2177
Mailing address
1280 Larpenteur Ave W
Apt. 323
Saint Paul, MN 55113-6340
Phone (651) 285-2449
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2193 | Other | MN | STATE OF MINNESOTA BOARD OF MEDICAL PRACTICE |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2193 | MN | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1401926400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1401926400000",
"number": "1275946394",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1280 LARPENTEUR AVE W",
"address_2": "APT. 323",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551136340",
"telephone_number": "651-285-2449"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5803 NEAL AVE N",
"city": "OAK PARK HEIGHTS",
"state": "MN",
"postal_code": "550822177",
"telephone_number": "651-351-2653"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AUGUSTINE",
"first_name": "MOLLY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-06-05",
"last_updated": "2014-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MN",
"license": "2193",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE OF MINNESOTA BOARD OF MEDICAL PRACTICE",
"identifier": "2193",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Oak Park Heights, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.