Individual provider Active NPI

Anneke Marie Hurley

  • Physician Assistant
  • Worthington, MN
National Provider Identifier
1497456503
Registry record updated Oct 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
15068 Issued in MN
Practice address
1680 Diagonal Rd
Worthington, MN 56187-1008
Phone
(507) 372-3800
NPI assigned
Mar 15, 2023
Last updated
Oct 31, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 15068 MN Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

1680 Diagonal Rd
Worthington, MN 56187-1008

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074

Other practice location 1

101 7th St SW
Orange City, IA 51041-1996
Phone (712) 707-7000

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
I20241108001726 MN Practitioner - Physician Assistant 0941734222 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanford Health NetworkGroup PAC ID 6800707100, 357 clinicians

Practice addresses (Care Compare)

1018 6TH Ave
Worthington, MN 56187-2202
Phone (507) 372-3800

1680 Diagonal Rd
Worthington, MN 56187-1008
Phone (507) 372-3800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
15068MNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Health Network CurrentSince Oct 14, 2024 Accepting new patients
Sanford Health Network CurrentSince Oct 14, 2024 Accepting new patients
Sanford Health Network Physician Assistant Past Accepting new patients

Locations

249 5th St E
Tracy, MN 56175
Phone (507) 629-3520

1018 6th Ave
Worthington, MN 56187
Phone (507) 343-6100

1680 Diagonal Rd
Worthington, MN 56187
Phone (507) 372-3800

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1678838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730332800000",
    "number": "1497456503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1680 DIAGONAL RD",
            "city": "WORTHINGTON",
            "state": "MN",
            "postal_code": "561871008",
            "telephone_number": "507-372-3800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 7th St SW",
            "address_purpose": "LOCATION",
            "city": "Orange City",
            "state": "IA",
            "postal_code": "510411996",
            "country_code": "US",
            "telephone_number": "712-707-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HURLEY",
        "first_name": "ANNEKE",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-15",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "15068",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worthington, MN

Sources for this page

Verify at the official NPI Registry.