Individual provider Active NPI

Erin Elizabeth Blackwell, APRN

  • Pediatric Nurse Practitioner
  • Edina, MN
National Provider Identifier
1649729088
Registry record updated Jan 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
CNP4905 Issued in MN
Practice address
5901 Lincoln Dr
Edina, MN 55436
Phone
(952) 992-5740
NPI assigned
Sep 27, 2016
Last updated
Jan 16, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X CNP4905 MN Primary
Registered Nurse 163W00000X R 183333-1 MN

Addresses

Primary practice location

5901 Lincoln Dr
Edina, MN 55436

Mailing address

5901 Lincoln Dr
Edina, MN 55436

Other names 1

  • Dr. Erin Elizabeth Igo Former name

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
I20161223000251 MN Practitioner - Nurse Practitioner 6709167117 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R 183333-1MNMDRegistered Nurse
CNP4905MNMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Clinic Network CurrentSince Aug 3, 2024 Accepting new patients
Children's Health Care CurrentSince Nov 28, 2016 Accepting new patients
Children's Clinic Network Current Accepting new patients
Children's Clinic Network CurrentSince Aug 3, 2024 Accepting new patients
Emergency Care Consultants, PA CurrentSince Oct 12, 2019 Accepting new patients
Red Balloon Urgent Care PLLC Pediatrics CurrentSince Jan 1, 2026 Accepting new patients
Childrens Health Care CurrentSince Nov 28, 2016 Accepting new patients
Childrens Health Care Current Accepting new patients
Metropolitan Pediatric Specialists, P.a. Past Accepting new patients
Childrens Health Care Past Accepting new patients
Ecc Addiction & Toxicology Services LLC Past Accepting new patients

Locations

2525 Chicago Ave
Minneapolis, MN 55404
Phone (612) 813-6000

7380 France Ave S
Ste 220
Minneapolis, MN 55435
Phone (651) 341-4291

800 E 28th St
Minneapolis, MN 55407
Phone (612) 863-3547

2855 Campus Dr
Plymouth, MN 55441
Phone (763) 577-7000

5901 Lincoln Dr
Saint Louis Park, MN 55436
Phone (952) 992-5691

5901 Lincoln Dr
#2
Saint Louis Park, MN 55436
Phone (952) 992-5691

347 Smith Ave N
Saint Paul, MN 55102
Phone (651) 220-6000

1547 Livingston Ave
West St Paul, MN 55118
Phone (651) 451-8050

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 11

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": "1474934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516060800000",
    "number": "1649729088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5901 LINCOLN DR",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "55436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5901 LINCOLN DR",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "55436",
            "telephone_number": "952-992-5740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKWELL",
        "first_name": "ERIN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-27",
        "last_updated": "2018-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MN",
            "license": "CNP4905",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "R 183333-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERIN",
            "last_name": "IGO",
            "middle_name": "ELIZABETH",
            "prefix": "DR.",
            "credential": "ARPN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Edina, MN

Sources for this page

Verify at the official NPI Registry.