Individual provider Active NPI

Pamela Nkowa, CNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Minneapolis, MN
National Provider Identifier
1740645522
Registry record updated Dec 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
CNP4316 Issued in MN
Practice address
1801 Nicollet Ave
Minneapolis, MN 55403-3791
Phone
(612) 596-9438
Fax
(612) 879-3822
NPI assigned
Dec 22, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X CNP4316 MN Primary

Addresses

Primary practice location

1801 Nicollet Ave
Minneapolis, MN 55403-3791

Mailing address

1801 Nicollet Ave
Minneapolis, MN 55403-3791
Phone (612) 596-9438

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
I20160616002185 MN Practitioner - Nurse Practitioner 2062703390 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hennepin CountyGroup PAC ID 7911892849, 132 clinicians

Practice addresses (Care Compare)

2215 E Lake St
Minneapolis, MN 55407-4385
Phone (612) 596-9438

Hospital & facility affiliations

  • Hennepin County Medical Center Hospital, Minneapolis, MN, CCN 240004

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
CNP4316MNMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hennepin County CurrentSince May 4, 2016 Accepting new patients
Hennepin County Psychiatric/Mental Health CurrentSince May 4, 2016 Accepting new patients

Locations

1801 Nicollet Ave
Minneapolis, MN 55403
Phone (612) 596-0900

2215 E Lake St
Minneapolis, MN 55407
Phone (612) 596-0900

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1450742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450742400000",
    "number": "1740645522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 NICOLLET AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554033791",
            "telephone_number": "612-596-9438",
            "fax_number": "612-879-3822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 NICOLLET AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554033791",
            "telephone_number": "612-596-9438",
            "fax_number": "612-879-3822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NKOWA",
        "first_name": "PAMELA",
        "name_prefix": "Ms.",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-22",
        "last_updated": "2015-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "CNP4316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.