Individual provider Active NPI

Stephanie Marie Glasspoole, MSN, CNP, FNP-C

  • Family Nurse Practitioner
  • Shakopee, MN
National Provider Identifier
1760026124
Registry record updated Mar 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
6986 Issued in MN
Practice address
4500 Dean Lakes Blvd
Shakopee, MN 55370
Phone
(866) 389-2727
NPI assigned
Oct 29, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 184695-9 MN
Nurse Practitioner 363L00000X 6989 MN
Nurse Practitioner 363L00000X 6986 MN
Family Nurse Practitioner 363LF0000X 6986 MN Primary

Addresses

Primary practice location

4500 Dean Lakes Blvd
Shakopee, MN 55370

Mailing address

4500 Dean Lakes Blvd
Shakopee, MN 55370
Phone (866) 389-2727

Other names 1

  • Stephanie Marie Anderson Former name

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
I20191120000247 MN Practitioner - Nurse Practitioner 9931531589 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Minuteclinic Diagnostic of Minnesota PAGroup PAC ID 7810289949, 83 clinicians

Practice addresses (Care Compare)

4050 Dean Lakes Blvd
Shakopee, MN 55379-2714
Phone (866) 389-2727

Merit-based Incentive Payment System (MIPS)

Final score
85.6 of 100Reported as group
Quality
72.5
Promoting interoperability
100
Improvement activities
40
Cost
77.07

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
184695-9MNMDRegistered Nurse
6986MNMDNurse Practitioner
6989MNMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic Diagnostic of Minnesota, P.a. Family CurrentSince Apr 10, 2025 Accepting new patients
Minuteclinic Primary Care Minnesota PLLC Family CurrentSince Sep 18, 2025 Accepting new patients

Locations

1500 109th Ave NE
Minneapolis, MN 55449
Phone (763) 354-1000

1010 W Lake St
Minneapolis, MN 55408
Phone (612) 822-1297

4050 Dean Lakes Blvd
Shakopee, MN 55379
Phone (952) 402-9039

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

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.

NPI Registry JSON

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

{
    "created_epoch": "1572307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743033600000",
    "number": "1760026124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 DEAN LAKES BLVD",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "55370",
            "telephone_number": "866-389-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 DEAN LAKES BLVD",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "55370",
            "telephone_number": "866-389-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASSPOOLE",
        "first_name": "STEPHANIE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "MSN, CNP, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-29",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "184695-9",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "6989",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "6986",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "6986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "ANDERSON",
            "middle_name": "MARIE",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Shakopee, MN

Sources for this page

Verify at the official NPI Registry.