Active NPI
Anne Pierce, RN, CNP
- Gerontology Nurse Practitioner
- Minnetrista, MN
National Provider Identifier
1366430621
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Nurse Practitioner
- License
- R63909-9
- Practice address
- 5520 Ridgewood CV
Minnetrista, MN 55364-8239 - Phone
- (612) 865-5262
- Fax
- (952) 472-3837
- NPI assigned
- Oct 11, 2005
- 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 |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | R63909-9 | MN | Primary |
Addresses
Primary practice location
5520 Ridgewood CV
Minnetrista, MN 55364-8239
Mailing address
12135 24TH Ave N
Plymouth, MN 55441-4123
Phone (763) 559-4437
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 109276600 | Medicaid | MN |
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)
- Enrolled
- Credentials
- Certified Nurse Practitioner, Nurse Practitioner, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R63909-9 | MN | MD | Gerontology Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Evercare Collaborative Solutions Inc | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Registered Nurse
- Minnetonka, MN
- NPI 1285686378
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128988800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1371686400000",
"number": "1366430621",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12135 24TH AVE N",
"city": "PLYMOUTH",
"state": "MN",
"postal_code": "554414123",
"telephone_number": "763-559-4437"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5520 RIDGEWOOD CV",
"city": "MINNETRISTA",
"state": "MN",
"postal_code": "553648239",
"telephone_number": "612-865-5262",
"fax_number": "952-472-3837"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PIERCE",
"first_name": "ANNE",
"credential": "RN, CNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-10-11",
"last_updated": "2013-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "MN",
"license": "R63909-9",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "109276600",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Minnetrista, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.