NPIMap

Organization Active NPI

Eagan Child and Family Care, P.a.

  • Pediatrics Physician
  • Eagan, MN
National Provider Identifier
1629000682
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
1650 Issued in MN
Legal business name
EAGAN CHILD AND FAMILY CARE, P.A.
Practice address
4178 Knob Dr
Suite a
Eagan, MN 55122-2888
Phone
(651) 209-8640
Fax
(651) 209-8690
NPI assigned
Jul 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Gretchen A Moen, CPNPNPI 1922034933
Title
President
Phone
(651) 209-8640

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 1650 MN
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X 1650 MN Primary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X 1650 MN
Pediatric Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0200X 1650 MN
Women's Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LW0102X 1650 MN

Addresses

Primary practice location

4178 Knob Dr
Suite a
Eagan, MN 55122-2888

Mailing address

4178 Knob Dr
Suite a
Eagan, MN 55122-2888
Phone (651) 209-8640

National Provider Directory

National Provider Directory

Locations

4178 Knob Dr
Ste A
Saint Paul, MN 55122
Phone (651) 209-8640

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1629000682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4178 KNOB DR",
            "address_2": "SUITE A",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551222888",
            "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": "4178 KNOB DR",
            "address_2": "SUITE A",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551222888",
            "telephone_number": "651-209-8640",
            "fax_number": "651-209-8690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGAN CHILD AND FAMILY CARE, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "MOEN",
        "authorized_official_first_name": "GRETCHEN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "651-209-8640",
        "authorized_official_credential": "CPNP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "1650",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "1650",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "1650",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MN",
            "license": "1650",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MN",
            "license": "1650",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagan, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.