Individual provider Active NPI

Maura Fitzgerald, CNS

  • Clinical Nurse Specialist
  • Minneapolis, MN
National Provider Identifier
1619942588
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Nurse SpecialistTaxonomy code 364S00000X
License
R0802800 Issued in MN
Practice address
2525 Chicago Avenue South
Childrens Specialty Clinic Integrative Medicine MPLS
Minneapolis, MN 55404
Phone
(612) 813-7997
Fax
(612) 813-7199
NPI assigned
Feb 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Nurse Specialist 364S00000X R0802800 MN Primary

Addresses

Primary practice location

2525 Chicago Avenue South
Childrens Specialty Clinic Integrative Medicine MPLS
Minneapolis, MN 55404

Mailing address

2910 Centre Pointe Drive
35 121A Childrens Health Care
Roseville, MN 55113
Phone (651) 855-2109

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)
Enrolled
Credentials
Certified Nurse Specialist

State licenses

LicenseStateTypeSpecialty
R0802800MNMDClinical Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619942588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2910 CENTRE POINTE DRIVE",
            "address_2": "35 121A CHILDRENS HEALTH CARE",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "55113",
            "telephone_number": "651-855-2109",
            "fax_number": "651-855-2310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 CHICAGO AVENUE SOUTH",
            "address_2": "CHILDRENS SPECIALTY CLINIC INTEGRATIVE MEDICINE MPLS",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55404",
            "telephone_number": "612-813-7997",
            "fax_number": "612-813-7199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZGERALD",
        "first_name": "MAURA",
        "credential": "CNS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "MN",
            "license": "R0802800",
            "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 Jul 8, 2007; 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.