Active NPI
Tucker J Annis
- Registered Nurse
- Minneapolis, MN
National Provider Identifier
1487138673
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 228652-1
- Practice address
- 1619 Grand St NE
Minneapolis, MN 55413-1031 - Phone
- (715) 892-8888
- NPI assigned
- Sep 24, 2018
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 228652-1 | MN | Primary |
Addresses
Primary practice location
1619 Grand St NE
Minneapolis, MN 55413-1031
Mailing address
1619 Grand St NE
Minneapolis, MN 55413-1031
Phone (715) 892-8888
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 |
|---|---|---|---|
| 228652-1 | MN | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1537747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1537747200000",
"number": "1487138673",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1619 GRAND ST NE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554131031",
"telephone_number": "715-892-8888"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1619 GRAND ST NE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554131031",
"telephone_number": "715-892-8888"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANNIS",
"first_name": "TUCKER",
"middle_name": "J",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-09-24",
"last_updated": "2018-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MN",
"license": "228652-1",
"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 Sep 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.