Individual provider Active NPI

Sarah Louise Isakson, GNP

  • Gerontology Nurse Practitioner
  • Minneapolis, MN
National Provider Identifier
1730128505
Registry record updated May 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
R113615-1 Issued in MN
Practice address
Mail Route 11414
800 E. 28TH Street
Minneapolis, MN 55407-3799
Phone
(612) 863-3110
Fax
(612) 863-3158
NPI assigned
Jun 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X R113615-1 MN Primary

Addresses

Primary practice location

Mail Route 11414
800 E. 28TH Street
Minneapolis, MN 55407-3799

Mailing address

3421 Roosevelt Street NE
St Anthony, MN 55418-1543
Phone (612) 590-0411

Other identifiers 1

IdentifierTypeStateIssuer
339797100MedicaidMN

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
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R113615-1MNMDGerontology Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368662400000",
    "number": "1730128505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3421 ROOSEVELT STREET NE",
            "city": "ST ANTHONY",
            "state": "MN",
            "postal_code": "554181543",
            "telephone_number": "612-590-0411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MAIL ROUTE 11414",
            "address_2": "800 E. 28TH STREET",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554073799",
            "telephone_number": "612-863-3110",
            "fax_number": "612-863-3158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISAKSON",
        "first_name": "SARAH",
        "middle_name": "LOUISE",
        "credential": "GNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-06",
        "last_updated": "2013-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MN",
            "license": "R113615-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "339797100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2013; 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.