Active NPI
Bonnie Kay Sedlacek, RN
- Critical Care Medicine Registered Nurse
- Minneapolis, MN
National Provider Identifier
1407444854
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Critical Care Medicine Registered Nurse
- License
- 1073793
- Practice address
- 3655 Central Ave NE
Minneapolis, MN 55418-1342 - Phone
- (612) 789-2460
- NPI assigned
- Dec 31, 2020
- Last updated
- Dec 31, 2020
- 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 |
|---|---|---|---|---|
| Critical Care Medicine Registered Nurse | 163WC0200X | 1073793 | WI | Primary |
Addresses
Primary practice location
3655 Central Ave NE
Minneapolis, MN 55418-1342
Mailing address
401 S 1St St Unit 809
Minneapolis, MN 55401-2565
Phone (612) 940-0573
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | RN | Direct |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1073793 | WI | MD | Critical Care Medicine Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grand St Paul CVS LLC | Past | Accepting new patients | |
| Grand St Paul CVS LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1609372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609372800000",
"number": "1407444854",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "401 S 1ST ST UNIT 809",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554012565",
"telephone_number": "612-940-0573"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3655 CENTRAL AVE NE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554181342",
"telephone_number": "612-789-2460"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SEDLACEK",
"first_name": "BONNIE",
"middle_name": "KAY",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-12-31",
"last_updated": "2020-12-31",
"certification_date": "2020-12-31",
"status": "A"
},
"taxonomies": [
{
"code": "163WC0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, Critical Care Medicine",
"state": "WI",
"license": "1073793",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "RN",
"affiliation": "N",
"endpointDescription": "RN",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "3655 Central Ave NE",
"city": "Minneapolis",
"state": "MN",
"country_code": "US",
"postal_code": "554181342",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Dec 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.