NPIMap

Organization Active NPI

New Dawn LLC

  • Nurse Practitioner
  • Shakopee, MN
National Provider Identifier
1659148161
Registry record updated Dec 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
NEW DAWN LLC
Practice address
904 Princeton Ave
Shakopee, MN 55379-4534
Phone
(612) 940-5651
NPI assigned
Dec 5, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2023

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

Authorized official

Name
Phoebe Kerubo Nyabando, NPNPI 1174190466
Title
Owner
Phone
(612) 940-5651

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363L00000X Primary

Addresses

Primary practice location

904 Princeton Ave
Shakopee, MN 55379-4534

Mailing address

904 Princeton Ave
Shakopee, MN 55379-4534
Phone (612) 940-5651

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1701734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701734400000",
    "number": "1659148161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 PRINCETON AVE",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553794534",
            "telephone_number": "612-940-5651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 PRINCETON AVE",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553794534",
            "telephone_number": "612-940-5651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW DAWN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-05",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-05",
        "status": "A",
        "authorized_official_last_name": "NYABANDO",
        "authorized_official_first_name": "PHOEBE",
        "authorized_official_middle_name": "KERUBO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-940-5651",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shakopee, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2023; 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.