Individual provider Active NPI

Anna Ross

  • Behavior Technician
  • Duluth, MN
National Provider Identifier
1346805041
Registry record updated Apr 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
1522 E Superior St
Duluth, MN 55812-1634
Phone
(218) 724-3122
NPI assigned
May 8, 2019
Last updated
Apr 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X NU Primary

Addresses

Primary practice location

1522 E Superior St
Duluth, MN 55812-1634

Mailing address

513 5TH Ave W
Grand Marais, MN 55604-3017
Phone (218) 387-2330

Other practice location 1

513 5th Ave W
Grand Marais, MN 55604-3017
Phone (218) 387-2330

Other names 1

  • Anna Axtell Former name

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sawtooth Mountain Clinic, Inc. CurrentSince Apr 28, 2024 Accepting new patients
The Duluth Clinic, LTD. PastSince Apr 28, 2024 Accepting new patients
Accend Services Incorporated PastSince Oct 25, 2021 Accepting new patients

Locations

513 5th Ave W
Grand Marais, MN 55604
Phone (218) 387-2330

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1557273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713830400000",
    "number": "1346805041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "513 5TH AVE W",
            "city": "GRAND MARAIS",
            "state": "MN",
            "postal_code": "556043017",
            "telephone_number": "218-387-2330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1522 E SUPERIOR ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558121634",
            "telephone_number": "218-724-3122"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "513 5th Ave W",
            "address_purpose": "LOCATION",
            "city": "Grand Marais",
            "state": "MN",
            "postal_code": "556043017",
            "country_code": "US",
            "telephone_number": "218-387-2330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSS",
        "first_name": "ANNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-08",
        "last_updated": "2024-04-23",
        "certification_date": "2024-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNA",
            "last_name": "AXTELL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Duluth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2024; 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.