Individual provider Active NPI

Wendy Cregg, NP-C

  • Family Nurse Practitioner
  • Waconia, MN
National Provider Identifier
1356698153
Registry record updated Dec 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CNP 0756 Issued in MN
Practice address
875 E Main St
Waconia, MN 55387-1081
Phone
(866) 389-2727
Fax
(401) 652-9119
NPI assigned
Aug 10, 2012
Last updated
Dec 5, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X CNP 0756 MN Primary

Addresses

Primary practice location

875 E Main St
Waconia, MN 55387-1081

Mailing address

875 E Main St
Waconia, MN 55387-1081
Phone (866) 389-2727

Other names 1

  • Wendy Hovland Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121114000431 MN Practitioner - Nurse Practitioner 6507017894 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CNP 0756MNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic Diagnostic of Minnesota, P.a. Family CurrentSince Jun 1, 2016 Accepting new patients

Locations

8225 Flying Cloud Dr
Eden Prairie, MN 55344
Phone (952) 563-0246

8251 Columbine Rd
Eden Prairie, MN 55344
Phone (952) 941-1266

1010 W Lake St
Minneapolis, MN 55408
Phone (612) 822-1297

1500 109th Ave NE
Minneapolis, MN 55449
Phone (763) 354-1000

900 Nicollet Mall
Minneapolis, MN 55403
Phone (612) 338-0085

875 E Main St
Waconia, MN 55387
Phone (952) 442-9333

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 1

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": "1344556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670198400000",
    "number": "1356698153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 E MAIN ST",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553871081",
            "telephone_number": "866-389-2727",
            "fax_number": "401-652-9119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 E MAIN ST",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553871081",
            "telephone_number": "866-389-2727",
            "fax_number": "401-652-9119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CREGG",
        "first_name": "WENDY",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-10",
        "last_updated": "2022-12-05",
        "certification_date": "2022-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "CNP 0756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WENDY",
            "last_name": "HOVLAND",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Waconia, MN

Sources for this page

Verify at the official NPI Registry.