Alicia M Teagarden, D.O.

Primary specialty

Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X

License

63503 Issued in MN

Practice address

2530 Chicago Ave Ste 400
Minneapolis, MN 55404

Phone

(612) 813-3300

Fax

(612) 813-3349

NPI assigned

May 11, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Alicia Granos Former name

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Children'S Respiratory & Critical Care Specialists. P.a.

  • Pediatric Pulmonology Physician
  • Minneapolis, MN
  • NPI 1003816505
  Medicare reassignment NPD
• Gillette Children'S Specialty Healthcare

  • Multi-Specialty Clinic/Center
  • St. Paul, MN
  • NPI 1225119175
  Medicare reassignment NPD
• North Memorial Health Care

  • General Acute Care Hospital
  • Robbinsdale, MN
  • NPI 1851344907
  Medicare reassignment NPD
• Gillette Children'S Specialty Healthcare

  • Multi-Specialty Clinic/Center
  • Saint Cloud, MN
  • NPI 1982090528
  NPD
• North Memorial Health Care

  • Clinic/Center
  • Blaine, MN
  • NPI 1841995552
  NPD
• North Memorial Health Care

  • Primary Care Clinic/Center
  • Minnetonka, MN
  • NPI 1952732729
  NPD
• Childrens Health Care

  • Children's Hospital
  • Minneapolis, MN
  • NPI 1881793750
  NPD (past)
• Gillette Children'S Specialty Healthcare

  • Multi-Specialty Clinic/Center
  • Minnetonka, MN
  • NPI 1598824880
  NPD (past)

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

{
    "created_epoch": "1305072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533600000000",
    "number": "1407148356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2530 CHICAGO AVE STE 400",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554044387",
            "telephone_number": "612-813-3300",
            "fax_number": "612-813-3349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2530 CHICAGO AVE STE 400",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55404",
            "telephone_number": "612-813-3300",
            "fax_number": "612-813-3349"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "705 Riley Hospital Dr",
            "address_2": "RI 4900",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462025109",
            "country_code": "US",
            "telephone_number": "317-948-7128",
            "fax_number": "317-944-3442",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "705 Riley Hospital Dr",
            "address_2": "RI 4900",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462025109",
            "country_code": "US",
            "telephone_number": "317-948-7128",
            "fax_number": "317-944-3442",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TEAGARDEN",
        "first_name": "ALICIA",
        "middle_name": "M",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-11",
        "last_updated": "2018-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "MN",
            "license": "63503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALICIA",
            "last_name": "GRANOS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Pediatric Critical Care Medicine Physician in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Pediatric Critical Care Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.