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Individual provider Active NPI

Anna Joy Neu, FNP

  • Nurse Practitioner
  • Detroit Lakes, MN
National Provider Identifier
1669603403
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R189426-0 Issued in MN
Practice address
1027 Washington Avenue
Detroit Lakes, MN 56501
Phone
(218) 847-5611
NPI assigned
Jul 28, 2009
Last updated
Apr 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R189426-0 MN Primary

Addresses

Primary practice location

1027 Washington Avenue
Detroit Lakes, MN 56501

Mailing address

824 N 11TH St
Montevideo, MN 56265-1629
Phone (320) 269-8877

Other practice location 1

824 N 11th St
Montevideo, MN 56265-1629
Phone (320) 269-8877

Other identifiers 1

IdentifierTypeStateIssuer
1669603403MedicaidMN

Other names 1

  • Anna Joy Walden Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100104000383 MN Practitioner - Nurse Practitioner 7416098165 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Marys Regional Health CenterGroup PAC ID 2062326820, 190 clinicians

Practice addresses (Care Compare)

1027 Washington Ave
Detroit Lakes, MN 56501-3409
Phone (218) 844-2300

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R189426-0MNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Health Services Current Accepting new patients
Fairview Clinics CurrentSince Aug 16, 2013 Accepting new patients
St Mary's Regional Health Center CurrentSince Sep 10, 2018 Accepting new patients
St. Marys Regional Health Center Current Accepting new patients
Fairview Health Services CurrentSince Aug 16, 2013 Accepting new patients
St Mary's Regional Health Center CurrentSince Sep 10, 2018 Accepting new patients

Locations

14101 Fairview Dr
Ste 300
Burnsville, MN 55337
Phone (612) 273-5400

1027 Washington Ave
Detroit Lakes, MN 56501
Phone (218) 844-2300

400 Stinson Blvd
#2
Minneapolis, MN 55413
Phone (612) 672-2294

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

Organizations & group practices 7

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1248739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714435200000",
    "number": "1669603403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "824 N 11TH ST",
            "city": "MONTEVIDEO",
            "state": "MN",
            "postal_code": "562651629",
            "telephone_number": "320-269-8877",
            "fax_number": "320-269-8186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1027 WASHINGTON AVENUE",
            "city": "DETROIT LAKES",
            "state": "MN",
            "postal_code": "56501",
            "telephone_number": "218-847-5611"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "824 N 11th St",
            "address_purpose": "LOCATION",
            "city": "Montevideo",
            "state": "MN",
            "postal_code": "562651629",
            "country_code": "US",
            "telephone_number": "320-269-8877",
            "fax_number": "320-269-8186",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEU",
        "first_name": "ANNA",
        "middle_name": "JOY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-28",
        "last_updated": "2024-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "R189426-0",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1669603403",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNA",
            "last_name": "WALDEN",
            "middle_name": "JOY",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Detroit Lakes, MN

Sources for this page

Verify at the official NPI Registry.