Individual provider Active NPI

Treasure T Takang-Enow, RN

  • Psychiatric/Mental Health Nurse Practitioner
  • Maple Grove, MN
National Provider Identifier
1336544022
Registry record updated Jan 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
11144 Issued in MN
Practice address
13603 80TH Cir N
Maple Grove, MN 55369-8961
Phone
(832) 497-7119
NPI assigned
Oct 24, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X 833234 TX
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 11144 MN Primary

Addresses

Primary practice location

13603 80TH Cir N
Maple Grove, MN 55369-8961

Mailing address

13603 80TH Cir N
Maple Grove, MN 55369-8961
Phone (832) 497-7119

Other identifiers 1

IdentifierTypeStateIssuer
146819MedicaidTX

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240213001249 MN Practitioner - Nurse Practitioner 7315380748 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1900 Silver Lake Rd NW
New Brighton, MN 55112-1786

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
833234TXMDGeneral Practice Registered Nurse
11144MNMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family Support Services Inc. CurrentSince Jan 15, 2024 Accepting new patients
Nystrom & Associates, LTD CurrentSince Jan 15, 2024 Accepting new patients

Locations

207 Jefferson Blvd
Big Lake, MN 55309
Phone (763) 367-6080

13603 80th Cir N
Maple Grove, MN 55369
Phone (763) 274-3120

1900 Silver Lake Rd NW
Ste 110
Saint Paul, MN 55112
Phone (651) 379-1718

1900 Silver Lake Rd NW
Saint Paul, MN 55112
Phone (651) 379-1704

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1414108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705622400000",
    "number": "1336544022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13603 80TH CIR N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553698961",
            "telephone_number": "832-497-7119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13603 80TH CIR N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553698961",
            "telephone_number": "832-497-7119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAKANG-ENOW",
        "first_name": "TREASURE",
        "middle_name": "T",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-24",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "TX",
            "license": "833234",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "11144",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "146819",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maple Grove, MN

Sources for this page

Verify at the official NPI Registry.