Individual provider Active NPI

Leslie Sandberg, RN

  • Registered Nurse
  • New York Mills, MN
National Provider Identifier
1407211816
Registry record updated Dec 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
R199565-1 Issued in MN
Practice address
102 Miller St
New York Mills, MN 56567-4333
Phone
(218) 385-2991
Fax
(218) 385-2992
NPI assigned
Dec 30, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R199565-1 MN Primary

Addresses

Primary practice location

102 Miller St
New York Mills, MN 56567-4333

Mailing address

PO Box 219
New York Mills, MN 56567-0219
Phone (218) 385-2991

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
R199565-1MNMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1451433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451433600000",
    "number": "1407211816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 219",
            "city": "NEW YORK MILLS",
            "state": "MN",
            "postal_code": "565670219",
            "telephone_number": "218-385-2991",
            "fax_number": "218-385-2992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 MILLER ST",
            "city": "NEW YORK MILLS",
            "state": "MN",
            "postal_code": "565674333",
            "telephone_number": "218-385-2991",
            "fax_number": "218-385-2992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDBERG",
        "first_name": "LESLIE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-30",
        "last_updated": "2015-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "R199565-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York Mills, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2015; 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.