Active NPI
Misty Reeder, FNP
- Nurse Practitioner
- Minnetonka, MN
National Provider Identifier
1700130671
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 1700130671
- Practice address
- 9900 Bren Rd E
Minnetonka, MN 55343-9664 - Phone
- (727) 242-3295
- NPI assigned
- Oct 31, 2012
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 1700130671 | FL | Primary |
Addresses
Primary practice location
9900 Bren Rd E
Minnetonka, MN 55343-9664
Mailing address
220 23Rd Ave S
St Petersburg, FL 33705-3232
Phone (727) 242-3295
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 008031200 | Medicaid | FL |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1700130671 | FL | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1351641600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1601856000000",
"number": "1700130671",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "220 23RD AVE S",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337053232",
"telephone_number": "727-242-3295"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9900 BREN RD E",
"city": "MINNETONKA",
"state": "MN",
"postal_code": "553439664",
"telephone_number": "727-242-3295"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REEDER",
"first_name": "MISTY",
"name_prefix": "Mrs.",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-10-31",
"last_updated": "2020-10-05",
"certification_date": "2020-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "FL",
"license": "1700130671",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "008031200",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Minnetonka, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.