Active NPI
M E McNutt, NP
- Adult Health Nurse Practitioner
- Minneapolis, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- R-141583-0
- 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
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 |
|---|---|---|---|---|
| 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, SD
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
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
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1372 | MN | MD | Physical Therapist |
| R-141583-0 | MN | MD | Adult Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Avera McKennan | Current | Accepting new patients | |
| Avera McKennan | Current | Accepting new patients | |
| Integrated Wound Care Minnesota PLLC | Current | Accepting new patients | |
| Avera McKennan | Current | Accepting new patients | |
| LTC Professionals, PLLC | Current | 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.
-
- General Practice Physician
- Delano, MN
- NPI 1205390457
-
- Internal Medicine Physician
- Bloomington, MN
- NPI 1417251935
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Sioux Falls, SD
- NPI 1699009944
-
- Diagnostic Radiology Physician
- Sioux Falls, SD
- NPI 1053680678
-
- Medical Specialty Clinic/Center
- Sioux Falls, SD
- NPI 1467695767
-
- Rheumatology Physician
- Coon Rapids, MN
- NPI 1952146516
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.