Individual provider Active NPI

Tara Nelson, MD

  • Family Medicine Physician
  • Cottage Grove, MN
National Provider Identifier
1447670104
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
59506 Issued in MN
Practice address
6939 Pine Arbor Dr S Ste 100
Cottage Grove, MN 55016-4643
Phone
(651) 326-5800
Fax
(651) 326-5802
NPI assigned
Apr 21, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 59506 MN Primary

Addresses

Primary practice location

6939 Pine Arbor Dr S Ste 100
Cottage Grove, MN 55016-4643

Mailing address

1414 Maryland Ave E
Saint Paul, MN 55106-2824
Phone (651) 793-5613

Other practice location 1

3850 Park Nicollet Blvd
St Louis Park, MN 55416-2527
Phone (952) 833-1000

Other practice location 2

1414 Maryland Ave E
Saint Paul, MN 55106-2824
Phone (651) 793-5613

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150804003359 MN Practitioner - Family Practice 1456665579 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Park Nicollet ClinicGroup PAC ID 7911819438, 1,778 clinicians

Practice addresses (Care Compare)

15800 95TH Ave N
Maple Grove, MN 55369-4400
Phone (952) 993-1440

300 Lake Dr E
Chanhassen, MN 55317-9302
Phone (952) 993-4300

3800 Park Nicollet Blvd
St Louis Park, MN 55416-2527
Phone (952) 993-3123

3850 Park Nicollet Blvd
St Louis Park, MN 55416-2527
Phone (952) 993-3123

5320 Hyland Greens Dr
Bloomington, MN 55437-3934
Phone (952) 993-2400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
59506MNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healtheast Medical Research Institute CurrentSince Sep 11, 2017 Accepting new patients
Healtheast Medical Research Institute CurrentSince Sep 11, 2017 Accepting new patients
Park Nicollet Clinic Family Medicine CurrentSince Aug 28, 2017 Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Park Nicollet Clinic Family Medicine CurrentSince Aug 28, 2017 Accepting new patients

Locations

6936 Pine Arbor Dr S
Ste 100
Cottage Grove, MN 55016
Phone (651) 326-5800

720 Washington Ave SE
Ste 300
Minneapolis, MN 55414
Phone (612) 884-0769

5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

1700 University Ave W
Fl 6
Saint Paul, MN 55104
Phone (651) 232-2273

2945 Hazelwood St
Ste 100
Saint Paul, MN 55109
Phone (651) 232-7800

3850 Park Nicollet Blvd
St Louis Park, MN 55416
Phone (952) 883-1000

1875 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-6700

Organizations & group practices 6

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1398038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1447670104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 MARYLAND AVE E",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551062824",
            "telephone_number": "651-793-5613",
            "fax_number": "651-495-0499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6939 PINE ARBOR DR S STE 100",
            "city": "COTTAGE GROVE",
            "state": "MN",
            "postal_code": "550164643",
            "telephone_number": "651-326-5800",
            "fax_number": "651-326-5802"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3850 Park Nicollet Blvd",
            "address_purpose": "LOCATION",
            "city": "St Louis Park",
            "state": "MN",
            "postal_code": "554162527",
            "country_code": "US",
            "telephone_number": "952-833-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1414 Maryland Ave E",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551062824",
            "country_code": "US",
            "telephone_number": "651-793-5613",
            "fax_number": "651-495-0499",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELSON",
        "first_name": "TARA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-21",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "59506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cottage Grove, MN

Sources for this page

Verify at the official NPI Registry.