Individual provider Active NPI

Delgermaa Stacy Robinson

  • Student in an Organized Health Care Education/Training Program
  • Golden Valley, MN
National Provider Identifier
1508532771
Registry record updated Mar 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
4800 Olson Memorial Highway
Suite 202
Golden Valley, MN 55422
Phone
(507) 474-6264
Fax
(507) 218-8553
NPI assigned
Aug 18, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X
Student in an Organized Health Care Education/Training Program 390200000X MN Primary

Addresses

Primary practice location

4800 Olson Memorial Highway
Suite 202
Golden Valley, MN 55422

Mailing address

4800 Olson Memorial Highway
Suite 202
Golden Valley, MN 55422
Phone (507) 474-6264

Other names 1

  • Delgermaa Otgontugs Former name

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

NPI Registry JSON

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

{
    "created_epoch": "1629244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709251200000",
    "number": "1508532771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 OLSON MEMORIAL HIGHWAY",
            "address_2": "SUITE 202",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "55422",
            "telephone_number": "507-474-6264",
            "fax_number": "507-218-8553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 OLSON MEMORIAL HIGHWAY",
            "address_2": "SUITE 202",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "55422",
            "telephone_number": "507-474-6264",
            "fax_number": "507-218-8553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBINSON",
        "first_name": "DELGERMAA",
        "middle_name": "STACY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-18",
        "last_updated": "2024-03-01",
        "certification_date": "2021-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DELGERMAA",
            "last_name": "OTGONTUGS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Golden Valley, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.