Individual provider Active NPI

Elizabeth Anastasia McDevitt, PMNHP

  • Psychiatric/Mental Health Nurse Practitioner
  • Coon Rapids, MN
National Provider Identifier
1508337551
Registry record updated Aug 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
6323 Issued in MN
Practice address
1930 Coon Rapids Blvd NW
Coon Rapids, MN 55433-4708
Phone
(763) 427-7964
Fax
(763) 427-7976
NPI assigned
Dec 16, 2018
Last updated
Aug 24, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 6323 MN Primary

Addresses

Primary practice location

1930 Coon Rapids Blvd NW
Coon Rapids, MN 55433-4708

Mailing address

3000 Ames Crossing Rd Ste 600
Eagan, MN 55121-2519
Phone (651) 774-0011

Other practice location 1

2120 Park Ave
Minneapolis, MN 55404-3378
Phone (612) 872-2000

Other practice location 2

317 York Ave
Saint Paul, MN 55130-4039
Phone (651) 774-0011

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
I20190416001533 MN Practitioner - Certified Clinical Nurse Specialist (CNS) 4284975426 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Clinical Nurse Specialist (CNS)
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
People IncorporatedGroup PAC ID 7012043540, 31 clinicians

Practice addresses (Care Compare)

1930 Coon Rapids Blvd NW
Coon Rapids, MN 55433-4708
Phone (651) 774-0011

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
People Incorporated CurrentSince Apr 15, 2019 Accepting new patients
People Incorporated CurrentSince Apr 15, 2019 Accepting new patients

Locations

1930 Coon Rapids Blvd NW
Minneapolis, MN 55433
Phone (763) 427-7964

2120 Park Ave
Minneapolis, MN 55404
Phone (612) 872-2000

3000 Ames Crossing Rd
Ste 600
Saint Paul, MN 55121
Phone (651) 288-3467

317 York Ave
Saint Paul, MN 55130
Phone (651) 771-0286

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1544918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692835200000",
    "number": "1508337551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 AMES CROSSING RD STE 600",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551212519",
            "telephone_number": "651-774-0011",
            "fax_number": "651-774-0606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 COON RAPIDS BLVD NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554334708",
            "telephone_number": "763-427-7964",
            "fax_number": "763-427-7976"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2120 Park Ave",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554043378",
            "country_code": "US",
            "telephone_number": "612-872-2000",
            "fax_number": "612-871-1375",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "317 York Ave",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551304039",
            "country_code": "US",
            "telephone_number": "651-774-0011",
            "fax_number": "651-774-0606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCDEVITT",
        "first_name": "ELIZABETH",
        "middle_name": "ANASTASIA",
        "credential": "PMNHP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-16",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "6323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coon Rapids, MN

Sources for this page

Verify at the official NPI Registry.