Individual provider Active NPI

Ruth S Thompson-Klabunde, GNP

  • Nurse Practitioner
  • Bloomington, MN
National Provider Identifier
1609842756
Registry record updated Oct 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1043244 Issued in MN
Practice address
8170 33Rd Ave S
Mc21106T
Bloomington, MN 55425-4516
Phone
(952) 883-6805
Fax
(952) 883-6117
NPI assigned
Feb 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2009

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 1043244 MN Primary

Addresses

Primary practice location

8170 33Rd Ave S
Mc21106T
Bloomington, MN 55425-4516

Mailing address

8170 33Rd Ave S
Mc21106T
Bloomington, MN 55425-4516
Phone (952) 883-6805

Other identifiers 1

IdentifierTypeStateIssuer
519016900MedicaidMN

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
I20091019000018 MN Practitioner - Nurse Practitioner 4880731249 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1043244MNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Group Health, Inc. CurrentSince Jan 1, 1999 Accepting new patients
Group Health, Inc. CurrentSince Jan 1, 1999 Accepting new patients
Regions Hospital Past Accepting new patients

Locations

1650 Beam Ave
Maplewood, MN 55109
Phone (651) 221-9051

8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375

8170 33rd Ave S
#21106T
Minneapolis, MN 55425
Phone (952) 883-6805

2220 Riverside Ave
Minneapolis, MN 55454
Phone (612) 371-1600

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

640 Jackson St
Saint Paul, MN 55101
Phone (651) 221-2164

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255996800000",
    "number": "1609842756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S",
            "address_2": "MC21106T",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554254516",
            "telephone_number": "952-883-6805",
            "fax_number": "952-883-6117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S",
            "address_2": "MC21106T",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554254516",
            "telephone_number": "952-883-6805",
            "fax_number": "952-883-6117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON-KLABUNDE",
        "first_name": "RUTH",
        "middle_name": "S",
        "credential": "GNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-28",
        "last_updated": "2009-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "1043244",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "519016900",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, MN

Sources for this page

Verify at the official NPI Registry.