Individual provider Active NPI

Emily Elizabeth Bunt, FNP

  • Family Nurse Practitioner
  • Robbinsdale, MN
National Provider Identifier
1720482565
Registry record updated Feb 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R164694-2 Issued in MN
Practice address
3300 Oakdale Ave N
Robbinsdale, MN 55422-2926
Phone
(763) 581-0962
NPI assigned
Oct 21, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R164694-2 MN Primary

Addresses

Primary practice location

3300 Oakdale Ave N
Robbinsdale, MN 55422-2926

Mailing address

12152 85TH Ave N
Maple Grove, MN 55369-4641
Phone (612) 214-4618

Other identifiers 1

IdentifierTypeStateIssuer
1720482565MedicaidMN

Other names 1

  • Emily Elizabeth Becker Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141226000028 MN Practitioner - Nurse Practitioner 9537482559 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R164694-2MNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Clinics CurrentSince Apr 8, 2017 Accepting new patients
Fairview Clinics CurrentSince Apr 8, 2017 Accepting new patients
Fairview Clinics Current Accepting new patients
Fairview Health Services CurrentSince Apr 8, 2017 Accepting new patients
Fairview Health Services Current Accepting new patients
Fairview Express Care Current Accepting new patients
Fairview Express Care CurrentSince Apr 8, 2017 Accepting new patients
Fairview Express Care CurrentSince Oct 1, 2020 Accepting new patients
Fairview Express Care CurrentSince Oct 1, 2020 Accepting new patients

Locations

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

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

3300 Oakdale Ave N
Robbinsdale, MN 55422
Phone (763) 520-5048

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1413849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486944000000",
    "number": "1720482565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12152 85TH AVE N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553694641",
            "telephone_number": "612-214-4618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 OAKDALE AVE N",
            "city": "ROBBINSDALE",
            "state": "MN",
            "postal_code": "554222926",
            "telephone_number": "763-581-0962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUNT",
        "first_name": "EMILY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-21",
        "last_updated": "2017-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "R164694-2",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1720482565",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "BECKER",
            "middle_name": "ELIZABETH",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Robbinsdale, MN

Sources for this page

Verify at the official NPI Registry.