Patricia A. Moen, M.S., ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

2666 Issued in MN

Practice address

10961 Clubwest Pkwy NE
Suite 200
Blaine, MN 55449

Phone

(763) 528-2992

NPI assigned

Apr 13, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Ms. Patricia A. Schank Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Allina Health System

  • General Acute Care Hospital
  • Minneapolis, MN
  • NPI 1760446256
  NPD (past)

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

{
    "created_epoch": "1144886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669939200000",
    "number": "1689638066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "349 120TH CIR NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554482415",
            "telephone_number": "630-930-9631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10961 CLUBWEST PKWY NE",
            "address_2": "SUITE 200",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "55449",
            "telephone_number": "763-528-2992"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1525 West Lincoln Highway",
            "address_2": "Convocation Center at Northern Illinois University",
            "address_purpose": "LOCATION",
            "city": "Dekalb",
            "state": "IL",
            "postal_code": "60115",
            "country_code": "US",
            "telephone_number": "815-753-9477",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11850 Blackfoot St NW",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554332578",
            "country_code": "US",
            "telephone_number": "952-946-9777",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOEN",
        "first_name": "PATRICIA",
        "middle_name": "A.",
        "name_prefix": "Mrs.",
        "credential": "M.S., ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-13",
        "last_updated": "2022-12-02",
        "certification_date": "2022-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IL",
            "license": "096-001286",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MN",
            "license": "2666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PATRICIA",
            "last_name": "SCHANK",
            "middle_name": "A.",
            "prefix": "MS.",
            "credential": "M.S., ATC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Athletic Trainer in Blaine, MN
• Providers in Blaine, MN by specialty
• Athletic Trainer in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2022; 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.