Active NPI
Tabitha Vachuska
- Personal Care Attendant
- Minneapolis, MN
National Provider Identifier
1447645544
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Personal Care Attendant
- License
- 47-2951436
- Practice address
- 1200 W Broadway Ave
Suite # 160
Minneapolis, MN 55411-2572 - Phone
- (612) 353-6308
- Fax
- (612) 886-2708
- NPI assigned
- Apr 6, 2015
- 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 |
|---|---|---|---|---|
| Personal Care Attendant | 3747P1801X | 47-2951436 | MN | Primary |
Addresses
Primary practice location
1200 W Broadway Ave
Suite # 160
Minneapolis, MN 55411-2572
Mailing address
1200 W Broadway Ave
Suite # 160
Minneapolis, MN 55411-2572
Phone (612) 353-6308
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 47-2951436 | MN | MD | Personal Care Attendant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1428278400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1428278400000",
"number": "1447645544",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 W BROADWAY AVE",
"address_2": "SUITE # 160",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554112572",
"telephone_number": "612-353-6308",
"fax_number": "612-886-2708"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 W BROADWAY AVE",
"address_2": "SUITE # 160",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554112572",
"telephone_number": "612-353-6308",
"fax_number": "612-886-2708"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VACHUSKA",
"first_name": "TABITHA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-04-06",
"last_updated": "2015-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "3747P1801X",
"taxonomy_group": "",
"desc": "Technician, Personal Care Attendant",
"state": "MN",
"license": "47-2951436",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"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 Apr 6, 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.