Individual provider Active NPI

M E McNutt, NP

  • Adult Health Nurse Practitioner
  • Minneapolis, MN
National Provider Identifier
1306032065
Registry record updated Jan 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
R-141583-0 Issued in MN
Practice address
2104 Northdale Blvd NW
Suite 220
Minneapolis, MN 55433-3028
Phone
(763) 507-6000
Fax
(763) 537-6666
NPI assigned
Sep 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X R-141583-0 MN Primary

Addresses

Primary practice location

2104 Northdale Blvd NW
Suite 220
Minneapolis, MN 55433-3028

Mailing address

2104 Northdale Blvd NW
Suite 220
Minneapolis, MN 55433-3028
Phone (763) 507-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, SD2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20080416000277 MN Practitioner - Nurse Practitioner 9537247549 Reassigns benefits to 2 organizations
I20200226001204 SD Practitioner - Nurse Practitioner 9537247549 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Wound Care Minnesota PLLCGroup PAC ID 2769722511, 14 clinicians

Practice addresses (Care Compare)

7700 Grand Ave
Duluth, MN 55807-2154
Phone (718) 705-6010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1372MNMDPhysical Therapist
R-141583-0MNMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Avera McKennan CurrentSince Feb 3, 2020 Accepting new patients
Avera McKennan Current Accepting new patients
Integrated Wound Care Minnesota PLLC CurrentSince Oct 29, 2023 Accepting new patients
Avera McKennan CurrentSince Feb 3, 2020 Accepting new patients
LTC Professionals, PLLC CurrentSince Oct 25, 2021 Accepting new patients
Allina Health System Past Accepting new patients

Locations

7700 Grand Ave
Duluth, MN 55807
Phone (218) 628-2341

7801 E Bush Lake Rd
Ste 400
Minneapolis, MN 55439
Phone (952) 283-3162

3131 France Ave N
Robbinsdale, MN 55422
Phone (763) 588-0771

492C Cedar Ln
Teaneck, NJ 07666
Phone (201) 357-5468

300 W 5th St
Miller, SD 57362
Phone (605) 853-0158

Organizations & group practices 6

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": "1189987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453075200000",
    "number": "1306032065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2104 NORTHDALE BLVD NW",
            "address_2": "SUITE 220",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554333028",
            "telephone_number": "763-507-6000",
            "fax_number": "763-537-6666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2104 NORTHDALE BLVD NW",
            "address_2": "SUITE 220",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554333028",
            "telephone_number": "763-507-6000",
            "fax_number": "763-537-6666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNUTT",
        "first_name": "M",
        "middle_name": "E",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-17",
        "last_updated": "2016-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MN",
            "license": "R-141583-0",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.