Individual provider Active NPI

Erin Melissa Schmidtke, MSN

  • Family Nurse Practitioner
  • Minneapolis, MN
National Provider Identifier
1285628792
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R1556537 Issued in MN
Practice address
324 E 35TH St
Minneapolis, MN 55408-4580
Phone
(612) 827-7181
NPI assigned
Sep 12, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R1556537 MN Primary

Addresses

Primary practice location

324 E 35TH St
Minneapolis, MN 55408-4580

Mailing address

5315 11TH Ave S
Minneapolis, MN 55417-1831
Phone (612) 824-1075

Other names 1

  • Ms. Erin Melissa Ruehle Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050413000884 MN Practitioner - Nurse Practitioner 1052367570 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
R1556537MNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
South Lake Clinic, P.a. CurrentSince Sep 17, 2016 Accepting new patients

Locations

6060 Clearwater Dr
Ste 240
Minnetonka, MN 55343
Phone (763) 762-8800

17705 Hutchins Dr
Ste 100
Minnetonka, MN 55345
Phone (763) 420-1010

17705 Hutchins Dr
Ste 250
Minnetonka, MN 55345

2805 Campus Dr
Ste 235
Plymouth, MN 55441

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.

NPI Registry JSON

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

{
    "created_epoch": "1126483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285628792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5315 11TH AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554171831",
            "telephone_number": "612-824-1075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 E 35TH ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554084580",
            "telephone_number": "612-827-7181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHMIDTKE",
        "first_name": "ERIN",
        "middle_name": "MELISSA",
        "name_prefix": "Mrs.",
        "credential": "MSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "R1556537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERIN",
            "last_name": "RUEHLE",
            "middle_name": "MELISSA",
            "prefix": "MS.",
            "credential": "MSN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.