Active NPI
Michelle Rene Beckman, FNP
- Family Nurse Practitioner
- Minneapolis, MN
National Provider Identifier
1508306937
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- R211615-4
- Practice address
- 3904 21St Ave S
Minneapolis, MN 55407-3070 - Phone
- (507) 340-6805
- NPI assigned
- Mar 4, 2017
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | R211615-4 | MN | Primary |
Addresses
Primary practice location
3904 21St Ave S
Minneapolis, MN 55407-3070
Mailing address
3904 21St Ave S
Minneapolis, MN 55407-3070
Phone (507) 340-6805
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508306937 | Other | MN | NPI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective May 31, 2023 through May 31, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R211615-4 | MN | MD | Family Nurse Practitioner |
Interoperability endpoints
- mbeckmanhowk482423@direct.centracare.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1488585600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694736000000",
"number": "1508306937",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3904 21ST AVE S",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554073070",
"telephone_number": "507-340-6805"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3904 21ST AVE S",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554073070",
"telephone_number": "507-340-6805"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BECKMAN",
"first_name": "MICHELLE",
"middle_name": "RENE",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-03-04",
"last_updated": "2023-09-15",
"certification_date": "2023-09-15",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MN",
"license": "R211615-4",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI",
"identifier": "1508306937",
"state": "MN"
}
],
"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 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.