Individual provider Active NPI

Michelle Simonet Christian, NP

  • Adult Health Nurse Practitioner
  • Burnsville, MN
National Provider Identifier
1508921909
Registry record updated Jan 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
0324295-21 Issued in MN
Practice address
2530 Horizon Dr
Burnsville, MN 55337-3091
Phone
(651) 209-8640
Fax
(651) 209-8690
NPI assigned
Dec 26, 2006
Last updated
Jan 21, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 0324295-21 MN Primary

Addresses

Primary practice location

2530 Horizon Dr
Burnsville, MN 55337-3091

Mailing address

2530 Horizon Dr
Burnsville, MN 55337-3091
Phone (651) 209-8640

Other practice location 1

7901 Xerxes Ave S Ste 116
Bloomington, MN 55431-1200
Phone (952) 888-2024

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
I20120201000875 MN Practitioner - Nurse Practitioner 3274790324 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0324295-21MNMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Open Door Health Center CurrentSince Aug 1, 2024 Accepting new patients
Open Door Health Center CurrentSince Aug 1, 2024 Accepting new patients

Locations

2530 Horizon Dr
Burnsville, MN 55337
Phone (651) 209-8640

309 Holly Ln
Mankato, MN 56001
Phone (507) 388-2120

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": "1167091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611187200000",
    "number": "1508921909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2530 HORIZON DR",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553373091",
            "telephone_number": "651-209-8640",
            "fax_number": "651-209-8690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2530 HORIZON DR",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553373091",
            "telephone_number": "651-209-8640",
            "fax_number": "651-209-8690"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7901 Xerxes Ave S Ste 116",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "MN",
            "postal_code": "554311200",
            "country_code": "US",
            "telephone_number": "952-888-2024",
            "fax_number": "952-888-3985",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHRISTIAN",
        "first_name": "MICHELLE",
        "middle_name": "SIMONET",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-26",
        "last_updated": "2021-01-21",
        "certification_date": "2021-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MN",
            "license": "0324295-21",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burnsville, MN

Sources for this page

Verify at the official NPI Registry.