Individual provider Active NPI

Heidi Lynn Gruenhagen, CPNP

  • Pediatric Nurse Practitioner
  • Minneapolis, MN
National Provider Identifier
1366888984
Registry record updated May 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
R176316-8 Issued in MN
Practice address
2530 Chicago Ave
Minneapolis, MN 55404-4289
Phone
(612) 874-1292
NPI assigned
May 22, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X R176316-8 MN Primary

Addresses

Primary practice location

2530 Chicago Ave
Minneapolis, MN 55404-4289

Mailing address

3424 Cherry LN Unit a
Woodbury, MN 55129-7727
Phone (507) 276-6909

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
I20170607001930 MN Practitioner - Nurse Practitioner 1052689460 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2530MNMDProfessional Counselor
R176316-8MNMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Health Care CurrentSince May 1, 2017 Accepting new patients
Childrens Health Care Current Accepting new patients
Childrens Health Care CurrentSince May 1, 2017 Accepting new patients
Childrens Health Care Past Accepting new patients

Locations

2530 Chicago Ave
Minneapolis, MN 55404
Phone (612) 813-6000

2525 Chicago Ave
Minneapolis, MN 55404
Phone (612) 813-6000

6060 Clearwater Dr
Ste 100
Minnetonka, MN 55343

5901 Lincoln Dr
#2
Saint Louis Park, MN 55436
Phone (952) 992-5691

347 Smith Ave N
Saint Paul, MN 55102
Phone (651) 220-6000

345 Smith Ave N
Saint Paul, MN 55102
Phone (651) 220-6000

628 Bielenberg Dr
Woodbury, MN 55125
Phone (612) 874-1292

Organizations & group practices 4

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": "1369180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369180800000",
    "number": "1366888984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3424 CHERRY LN UNIT A",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551297727",
            "telephone_number": "507-276-6909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2530 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554044289",
            "telephone_number": "612-874-1292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUENHAGEN",
        "first_name": "HEIDI",
        "middle_name": "LYNN",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-22",
        "last_updated": "2013-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MN",
            "license": "R176316-8",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.