Erving Wayne London, CNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

R0779645 Issued in MN

Practice address

4600 Lake Road Ave Ste 301
Robbinsdale, MN 55422-1845

Phone

(763) 588-7099

Fax

(763) 522-2222

NPI assigned

Apr 26, 2006

Last updated

Feb 21, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Medical Consultants Clinic PA

  • Clinic/Center
  • Robbinsdale, MN
  • NPI 1447711015
  NPD (past)

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519171200000",
    "number": "1730145764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 LAKE ROAD AVE STE 301",
            "city": "ROBBINSDALE",
            "state": "MN",
            "postal_code": "554221845",
            "telephone_number": "763-588-7099",
            "fax_number": "763-522-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 LAKE ROAD AVE STE 301",
            "city": "ROBBINSDALE",
            "state": "MN",
            "postal_code": "554221845",
            "telephone_number": "763-588-7099",
            "fax_number": "763-522-2222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9550 Upland Ln N",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Maple Grove",
            "state": "MN",
            "postal_code": "553694481",
            "country_code": "US",
            "telephone_number": "763-537-6000",
            "fax_number": "763-537-6666",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LONDON",
        "first_name": "ERVING",
        "middle_name": "WAYNE",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2018-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "R0779645",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "894628100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Alan W Litts, MD
• Delaney Long, MS, RD, PA-C
• Troy Dean Long, MD
• Amy E Look, PH.D.
• Yia Lor
• Christina Marie Luke, PHARMD

• Nurse Practitioner in Robbinsdale, MN
• Providers in Robbinsdale, MN by specialty
• Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2018; 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.