Individual provider Active NPI

Danielle Nicole Anderson, FNP-C

  • Family Nurse Practitioner
  • Maple Grove, MN
National Provider Identifier
1629778014
Registry record updated Apr 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9994 Issued in MN
Practice address
9645 Grove Cir N Ste 200
Maple Grove, MN 55369-2684
Phone
(763) 201-8191
Fax
(763) 201-8192
NPI assigned
Mar 6, 2023
Last updated
Apr 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 9994 MN Primary

Addresses

Primary practice location

9645 Grove Cir N Ste 200
Maple Grove, MN 55369-2684

Mailing address

9645 Grove Cir N Ste 200
Maple Grove, MN 55369-2684
Phone (763) 201-8191

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
I20230324000912 MN Practitioner - Nurse Practitioner 2163896671 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
Group practices
Interventional Spine and Pain Physicians PAGroup PAC ID 2466606264, 42 clinicians

Practice addresses (Care Compare)

9645 Grove Cir N
Suite 200
Maple Grove, MN 55369-2684
Phone (763) 201-8191

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Interventional Spine and Pain Physicians, PA CurrentSince Mar 3, 2023 Accepting new patients
Anesthesia Associates, PLLC PastSince Jul 15, 2023 Accepting new patients

Locations

14000 Nicollet Ave
Ste 104
Burnsville, MN 55337

3000 Hundertmark Rd
Ste 250
Chaska, MN 55318
Phone (507) 625-7246

320 Coon Rapids Blvd NW
Coon Rapids, MN 55433
Phone (763) 201-8091

320 Coon Rapids Blvd NW
Ste 100
Coon Rapids, MN 55433
Phone (952) 908-2580

916 Saint Peter Ave E
Delano, MN 55328
Phone (763) 972-9172

7700 France Ave S
Ste 260
Edina, MN 55435

9600 Upland Ln N
Ste 160
Maple Grove, MN 55369

9645 Grove Cir N
Ste 200
Maple Grove, MN 55369
Phone (763) 300-2193

1856 Beam Ave
#100
Maplewood, MN 55109

1601 Saint Francis Ave
Ste 200
Shakopee, MN 55379
Phone (952) 428-2001

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1678060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680825600000",
    "number": "1629778014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9645 GROVE CIR N STE 200",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553692684",
            "telephone_number": "763-201-8191",
            "fax_number": "763-201-8192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9645 GROVE CIR N STE 200",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553692684",
            "telephone_number": "763-201-8191",
            "fax_number": "763-201-8192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "DANIELLE",
        "middle_name": "NICOLE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-06",
        "last_updated": "2023-04-07",
        "certification_date": "2023-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "9994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maple Grove, MN

Sources for this page

Verify at the official NPI Registry.