Individual provider Active NPI

Daniel Augustine, CAPS

  • Home Modifications Contractor
  • Minneapolis, MN
National Provider Identifier
1376713818
Registry record updated Apr 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Modifications ContractorTaxonomy code 171WH0202X
License
20065360 Issued in MN
Practice address
509 W 22ND St
LL
Minneapolis, MN 55405-3202
Phone
(612) 724-1911
Fax
(612) 724-1851
NPI assigned
Mar 11, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Modifications Contractor 171WH0202X 20065360 MN Primary

Addresses

Primary practice location

509 W 22ND St
LL
Minneapolis, MN 55405-3202

Mailing address

509 W 22ND St
LL
Minneapolis, MN 55405-3202
Phone (612) 724-1911

Other identifiers 2

IdentifierTypeStateIssuer
171562OtherMNU CARE MN
715314700MedicaidMN

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

State licenses

LicenseStateTypeSpecialty
20065360MNMDHome Modifications Contractor

NPI Registry JSON

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

{
    "created_epoch": "1205193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303171200000",
    "number": "1376713818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 W 22ND ST",
            "address_2": "LL",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554053202",
            "telephone_number": "612-724-1911",
            "fax_number": "612-724-1851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 W 22ND ST",
            "address_2": "LL",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554053202",
            "telephone_number": "612-724-1911",
            "fax_number": "612-724-1851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AUGUSTINE",
        "first_name": "DANIEL",
        "name_prefix": "Mr.",
        "credential": "CAPS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-03-11",
        "last_updated": "2011-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171WH0202X",
            "taxonomy_group": "",
            "desc": "Contractor, Home Modifications",
            "state": "MN",
            "license": "20065360",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "U CARE MN",
            "identifier": "171562",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "715314700",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2011; 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.