Individual provider Active NPI

Sara Vipond

  • Psychiatric/Mental Health Nurse Practitioner
  • Edina, MN
National Provider Identifier
1417616764
Registry record updated Apr 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
8845 Issued in MN
Practice address
7201 Metro Blvd Ste 550
Edina, MN 55439-1353
Phone
(952) 283-0788
NPI assigned
Dec 14, 2021
Last updated
Apr 27, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 8845 MN Primary

Addresses

Primary practice location

7201 Metro Blvd Ste 550
Edina, MN 55439-1353

Mailing address

7201 Metro Blvd Ste 550
Edina, MN 55439-1353
Phone (952) 283-0788

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
I20220131001418 MN Practitioner - Nurse Practitioner 5597158329 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Danielle Golden, Crna, PAGroup PAC ID 6305934597, 30 clinicians

Practice addresses (Care Compare)

12000 Elm Creek Blvd
Suite 305
Maple Grove, MN 55369-7048
Phone (952) 431-5330

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8845MNMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Danielle Golden, Crna, PA Multi-Specialty CurrentSince Nov 7, 2024 Accepting new patients
Family Innovations, Inc. Multi-Specialty Past Accepting new patients

Locations

12000 Elm Creek Blvd N
Ste 305
Maple Grove, MN 55369

12000 Elm Creek Blvd N
Ste L70
Maple Grove, MN 55369
Phone (763) 420-4111

3555 Willow Lake Blvd
Ste 290
Vadnais Heights, MN 55110

3640 Talmage Cir
Ste 216
Vadnais Hts, MN 55110
Phone (651) 379-4006

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": "1639440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714176000000",
    "number": "1417616764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7201 METRO BLVD STE 550",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554391353",
            "telephone_number": "952-283-0788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7201 METRO BLVD STE 550",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554391353",
            "telephone_number": "952-283-0788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIPOND",
        "first_name": "SARA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-14",
        "last_updated": "2024-04-27",
        "certification_date": "2024-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "8845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

Verify at the official NPI Registry.