Individual provider Active NPI

Nancy L Ruppenthal, LICSW

  • Clinical Social Worker
  • Minneapolis, MN
National Provider Identifier
1730214883
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
9073 Issued in MN
Practice address
2205 California St NE
#200C
Minneapolis, MN 55418-3348
Phone
(612) 789-2653
NPI assigned
Feb 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 9073 MN Primary

Addresses

Primary practice location

2205 California St NE
#200C
Minneapolis, MN 55418-3348

Mailing address

2205 California St NE
#200C
Minneapolis, MN 55418-3348
Phone (612) 789-2653

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
9073MNMDSports Physical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730214883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2205 CALIFORNIA ST NE",
            "address_2": "#200C",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554183348",
            "telephone_number": "612-789-2653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2205 CALIFORNIA ST NE",
            "address_2": "#200C",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554183348",
            "telephone_number": "612-789-2653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUPPENTHAL",
        "first_name": "NANCY",
        "middle_name": "L",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "9073",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jul 8, 2007; 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.