Individual provider Active NPI

Cherisse C. Sardon Garrity, R.N., N.P.

  • Nurse Practitioner
  • Minneapolis, MN
National Provider Identifier
1457572968
Registry record updated Mar 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2801 Issued in MN
Practice address
525 Portland Ave Ste 300
Minneapolis, MN 55415-1533
Phone
(612) 348-5553
NPI assigned
May 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 2157074 MN
Nurse Practitioner 363L00000X 2801 MN Primary

Addresses

Primary practice location

525 Portland Ave Ste 300
Minneapolis, MN 55415-1533

Mailing address

525 Portland Ave Ste 300
Minneapolis, MN 55415-1533
Phone (612) 348-5553

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
I20140418000195 MN Practitioner - Nurse Practitioner 5991937203 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hennepin CountyGroup PAC ID 7911892849, 132 clinicians

Practice addresses (Care Compare)

525 Portland Ave
Minneapolis, MN 55415-1569

525 Portland Ave S MC
Minneapolis, MN 55415-1569

614 S 3Rd St
Minneapolis, MN 55415-1104
Phone (612) 348-5553

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2157074MNMDRegistered Nurse
2801MNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hennepin County CurrentSince Jul 30, 2019 Accepting new patients
Hennepin County Current Accepting new patients

Locations

525 Portland Ave
Minneapolis, MN 55415
Phone (612) 348-8824

525 Portland Ave
Ste 300
Minneapolis, MN 55415

525 Portland Ave
#963
Minneapolis, MN 55415
Phone (612) 348-2233

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": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522022400000",
    "number": "1457572968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 PORTLAND AVE STE 300",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554151533",
            "telephone_number": "612-348-5553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 PORTLAND AVE STE 300",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554151533",
            "telephone_number": "612-348-5553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SARDON GARRITY",
        "first_name": "CHERISSE",
        "middle_name": "C.",
        "credential": "R.N., N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2018-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "2157074",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "2801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.