NPIMap

Individual provider Active NPI

Cassandra Miles-Hanson, DNP/FNP

  • Nurse Practitioner
  • Faribault, MN
National Provider Identifier
1609580208
Registry record updated Jul 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F12220232 Issued in MN
Practice address
300 State Ave
Faribault, MN 55021-6319
Phone
(507) 333-3300
NPI assigned
Jan 9, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X F12220232 MN Primary

Addresses

Primary practice location

300 State Ave
Faribault, MN 55021-6319

Mailing address

300 State Ave
Faribault, MN 55021-6319
Phone (507) 333-3300

Other practice location 1

5540 10th Ave S
Minneapolis, MN 55417-2402
Phone (612) 819-1420

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cmileshanson1943632@ehrdirect.mayoclinicmsg.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230403001352 MN Practitioner - Nurse Practitioner 5698140796 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

300 State Ave
Faribault, MN 55021-6319
Phone (507) 333-3300

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9857MNMDMedical Physician Assistant
F12220232MNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Health System-Southeast Minnesota Region CurrentSince Mar 21, 2023 Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region CurrentSince Mar 21, 2023 Accepting new patients

Locations

404 W Fountain St
Albert Lea, MN 56007
Phone (507) 377-6285

300 State Ave
Faribault, MN 55021
Phone (507) 333-3300

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

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 and National Provider Directory roles.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1673222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688342400000",
    "number": "1609580208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 STATE AVE",
            "city": "FARIBAULT",
            "state": "MN",
            "postal_code": "550216319",
            "telephone_number": "507-333-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 STATE AVE",
            "city": "FARIBAULT",
            "state": "MN",
            "postal_code": "550216319",
            "telephone_number": "507-333-3300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5540 10th Ave S",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554172402",
            "country_code": "US",
            "telephone_number": "612-819-1420",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILES-HANSON",
        "first_name": "CASSANDRA",
        "credential": "DNP/FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-09",
        "last_updated": "2023-07-03",
        "certification_date": "2023-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "F12220232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cmileshanson1943632@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "300 State Ave",
            "city": "Faribault",
            "state": "MN",
            "country_code": "US",
            "postal_code": "550216319",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Faribault, MN

Sources for this page

Verify at the official NPI Registry.