Individual provider Active NPI

Meaghan Herdina, ATC

  • Athletic Trainer
  • Minneapolis, MN
National Provider Identifier
1750963674
Registry record updated Apr 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
030802048 Issued in MN
Practice address
2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone
(612) 262-8000
NPI assigned
Apr 21, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 030802048 MN Primary

Addresses

Primary practice location

2925 Chicago Ave
Minneapolis, MN 55407-1321

Mailing address

4111 Auburn Dr
Minnetonka, MN 55305-5139
Phone (612) 242-6704

Other practice location 1

2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (612) 262-8000

Other practice location 2

2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (612) 262-8000

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Epic

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
030802048MNMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1618963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618963200000",
    "number": "1750963674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4111 AUBURN DR",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553055139",
            "telephone_number": "612-242-6704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2925 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071321",
            "telephone_number": "612-262-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2925 Chicago Ave",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554071321",
            "country_code": "US",
            "telephone_number": "612-262-8000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2925 Chicago Ave",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554071321",
            "country_code": "US",
            "telephone_number": "612-262-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERDINA",
        "first_name": "MEAGHAN",
        "name_prefix": "Ms.",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-21",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MN",
            "license": "030802048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Epic",
            "affiliation": "N",
            "endpointDescription": "EMR",
            "address_1": "2925 Chicago Ave",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554071321",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Apr 21, 2021; 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.