Active NPI
Theresa Williams
- Nurse's Aide
- Brooklyn Park, MN
National Provider Identifier
1295042042
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse's Aide
- Practice address
- 6450 67TH Ave N
Brooklyn Park, MN 55428-2468 - Phone
- (763) 291-1716
- NPI assigned
- Aug 31, 2010
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Nurse's Aide | 376K00000X | MN | Primary |
Addresses
Primary practice location
6450 67TH Ave N
Brooklyn Park, MN 55428-2468
Mailing address
5775 Wayzata Blvd
Suite 700
Minneapolis, MN 55416-1222
Phone (763) 291-1716
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 348032 | Other | MN | CLASS A PROFESSIONAL HOME HEALTH CARE AGENCY |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1283212800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1283212800000",
"number": "1295042042",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5775 WAYZATA BLVD",
"address_2": "SUITE 700",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554161222",
"telephone_number": "763-291-1716"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6450 67TH AVE N",
"city": "BROOKLYN PARK",
"state": "MN",
"postal_code": "554282468",
"telephone_number": "763-291-1716"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "THERESA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-08-31",
"last_updated": "2010-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "376K00000X",
"taxonomy_group": "",
"desc": "Nurse's Aide",
"state": "MN",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CLASS A PROFESSIONAL HOME HEALTH CARE AGENCY",
"identifier": "348032",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn Park, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.