Individual provider Active NPI

Banchi Alebachew

  • Gerontology Registered Nurse
  • Minneapolis, MN
National Provider Identifier
1295257756
Registry record updated Jul 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Registered NurseTaxonomy code 163WG0600X
License
R198098-3 Issued in MN
Practice address
5101 Minnehaha Ave
Minneapolis, MN 55417-1647
Phone
(651) 497-8683
NPI assigned
Jul 16, 2017
Last updated
Jul 16, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Registered Nurse 163WG0600X R198098-3 MN Primary

Addresses

Primary practice location

5101 Minnehaha Ave
Minneapolis, MN 55417-1647

Mailing address

17260 Glencoe Ave
Lakeville, MN 55044-7423
Phone (651) 497-8683

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

LicenseStateTypeSpecialty
R198098-3MNMDGerontology Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1500163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500163200000",
    "number": "1295257756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17260 GLENCOE AVE",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550447423",
            "telephone_number": "651-497-8683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5101 MINNEHAHA AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554171647",
            "telephone_number": "651-497-8683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALEBACHEW",
        "first_name": "BANCHI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-16",
        "last_updated": "2017-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0600X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Gerontology",
            "state": "MN",
            "license": "R198098-3",
            "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 Jul 16, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.