Active NPI
Nathan McCormick
- Mental Health Counselor
- Anoka, MN
National Provider Identifier
1306511464
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 02882
- Practice address
- 1833 3Rd Ave
Anoka, MN 55303-2424 - Phone
- (763) 234-1122
- NPI assigned
- Aug 11, 2021
- Last updated
- Aug 11, 2021
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 02882 | MN | Primary |
Addresses
Primary practice location
1833 3Rd Ave
Anoka, MN 55303-2424
Mailing address
15172 Uplander St NW
Andover, MN 55304-2659
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: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1833 3Rd Ave
Anoka, MN 55303-2424
Phone (763) 421-5535
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 02882 | MN | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Innovations, Inc. | Current | Accepting new patients | |
| West Central Counseling LLC | Mental Health | Past | Accepting new patients |
Locations
121 5th Ave W
Alexandria, MN 56308
Phone (320) 759-3096
1833 3rd Ave
Anoka, MN 55303
Phone (763) 421-5535
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Mental Health Counselor
- Alexandria, MN
- NPI 1649846650
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1628640000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1628640000000",
"number": "1306511464",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15172 UPLANDER ST NW",
"city": "ANDOVER",
"state": "MN",
"postal_code": "553042659"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1833 3RD AVE",
"city": "ANOKA",
"state": "MN",
"postal_code": "553032424",
"telephone_number": "763-234-1122"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCORMICK",
"first_name": "NATHAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-08-11",
"last_updated": "2021-08-11",
"certification_date": "2021-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MN",
"license": "02882",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Anoka, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2021; 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.