Individual provider Active NPI

Ashley Noel Childers, CNP

  • Family Nurse Practitioner
  • Bloomington, MN
National Provider Identifier
1407563463
Registry record updated Nov 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9657 Issued in MN
Practice address
8936 Lyndale Ave S # 3060
Bloomington, MN 55420-2742
Phone
(952) 881-0163
NPI assigned
Oct 31, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 9657 MN Primary

Addresses

Primary practice location

8936 Lyndale Ave S # 3060
Bloomington, MN 55420-2742

Mailing address

1278 Norway PT Apt 8
Eagan, MN 55123-2301
Phone (424) 567-2292

Other practice location 1

1278 Norway Pt Apt 8
Eagan, MN 55123-2301
Phone (424) 567-2292

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
I20230117000495 MN Practitioner - Nurse Practitioner 5193196897 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Minuteclinic Diagnostic of Minnesota PAGroup PAC ID 7810289949, 83 clinicians
Minuteclinic Primary Care Minnesota PLLCGroup PAC ID 2163945460, 30 clinicians

Practice addresses (Care Compare)

1040 Grand Ave
Saint Paul, MN 55105-3001
Phone (866) 389-2727

1500 109TH Ave NE
Blaine, MN 55449-4670
Phone (866) 389-2727

6905 York Ave S
Edina, MN 55435-2517
Phone (866) 389-2727

8936 Lyndale Ave S
Bloomington, MN 55420-2742
Phone (866) 389-2727

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9657MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic Diagnostic of Minnesota, P.a. Family CurrentSince Nov 29, 2022 Accepting new patients
Minuteclinic Primary Care Minnesota PLLC Family CurrentSince Apr 1, 2025 Accepting new patients

Locations

1010 W Lake St
Minneapolis, MN 55408
Phone (612) 822-1297

8936 Lyndale Ave S
Minneapolis, MN 55420
Phone (952) 881-0163

1500 109th Ave NE
Minneapolis, MN 55449
Phone (763) 354-1000

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1667174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667433600000",
    "number": "1407563463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1278 NORWAY PT APT 8",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551232301",
            "telephone_number": "424-567-2292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8936 LYNDALE AVE S # 3060",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554202742",
            "telephone_number": "952-881-0163"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1278 Norway Pt Apt 8",
            "address_purpose": "LOCATION",
            "city": "Eagan",
            "state": "MN",
            "postal_code": "551232301",
            "country_code": "US",
            "telephone_number": "424-567-2292",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHILDERS",
        "first_name": "ASHLEY",
        "middle_name": "NOEL",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-31",
        "last_updated": "2022-11-03",
        "certification_date": "2022-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "9657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, MN

Sources for this page

Verify at the official NPI Registry.