Individual provider Active NPI

Deqa Adan, CHW

  • Community Health Worker
  • Minneapolis, MN
National Provider Identifier
1518406024
Registry record updated Feb 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
Practice address
311 University Ave NE
101
Minneapolis, MN 55413-1379
Phone
(612) 430-0036
NPI assigned
Feb 16, 2017
Last updated
Feb 16, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 16, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X MN Primary

Addresses

Primary practice location

311 University Ave NE
101
Minneapolis, MN 55413-1379

Mailing address

724 20TH Ave S
Minneapolis, MN 55454-1329
Phone (612) 636-9728

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": "1487203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487203200000",
    "number": "1518406024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "724 20TH AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554541329",
            "telephone_number": "612-636-9728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 UNIVERSITY AVE NE",
            "address_2": "101",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554131379",
            "telephone_number": "612-430-0036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADAN",
        "first_name": "DEQA",
        "credential": "CHW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-16",
        "last_updated": "2017-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Feb 16, 2017; 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.