Active NPI
Gladys Ayiera Ndege, CNP
- Psychiatric/Mental Health Nurse Practitioner
- Plymouth, MN
National Provider Identifier
1659045391
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 8338
- Practice address
- 1145 Shenandoah LN N
Plymouth, MN 55447-3201 - Phone
- (763) 464-6462
- NPI assigned
- Aug 5, 2021
- Last updated
- May 7, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 202185 | ND | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 10041687 | OR | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 8338 | MN | Primary |
Addresses
Primary practice location
1145 Shenandoah LN N
Plymouth, MN 55447-3201
Mailing address
1145 Shenandoah LN N
Plymouth, MN 55447-3201
Phone (763) 464-6462
Other practice location 1
555 SE Mlk Jr Blvd Unit 105
Portland, OR 97214-2595
Phone (602) 430-9646
Other practice location 2
3523 45th St S Ste 100
Fargo, ND 58104-8962
Phone (604) 430-9646
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 Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 202185 | ND | MD | Psychiatric/Mental Health Nurse Practitioner |
| 10041687 | OR | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hopegrows Behavioral Health | Psychiatric/Mental Health | Current | Accepting new patients |
| Mindful Support Network Limited | Current | Accepting new patients |
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.
-
- Psychiatric/Mental Health Nurse Practitioner
- Champlin, MN
- NPI 1477318319
-
- Respite Care
- Brooklyn Park, MN
- NPI 1801787015
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1628121600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1746576000000",
"number": "1659045391",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1145 SHENANDOAH LN N",
"city": "PLYMOUTH",
"state": "MN",
"postal_code": "554473201",
"telephone_number": "763-464-6462"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1145 SHENANDOAH LN N",
"city": "PLYMOUTH",
"state": "MN",
"postal_code": "554473201",
"telephone_number": "763-464-6462"
}
],
"practiceLocations": [
{
"address_1": "555 SE Mlk Jr Blvd Unit 105",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "OR",
"postal_code": "972142595",
"country_code": "US",
"telephone_number": "602-430-9646",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3523 45th St S Ste 100",
"address_purpose": "LOCATION",
"city": "Fargo",
"state": "ND",
"postal_code": "581048962",
"country_code": "US",
"telephone_number": "604-430-9646",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NDEGE",
"first_name": "GLADYS",
"middle_name": "AYIERA",
"credential": "CNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-08-05",
"last_updated": "2025-05-07",
"certification_date": "2025-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "ND",
"license": "202185",
"primary": false
},
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "OR",
"license": "10041687",
"primary": false
},
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "MN",
"license": "8338",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Plymouth, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 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.