Individual provider Active NPI

David C Prindle, LICSW

  • Clinical Social Worker
  • Minnetonka, MN
National Provider Identifier
1760546907
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
4923 Issued in MN
Practice address
15320 Minnetonka Blvd
#200
Minnetonka, MN 55345
Phone
(952) 932-7277
Fax
(952) 932-9827
NPI assigned
Dec 21, 2006
Sex
Male
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 4923 MN Primary

Addresses

Primary practice location

15320 Minnetonka Blvd
#200
Minnetonka, MN 55345

Mailing address

15320 Minnetonka Blvd
#200 Relate Inc
Minnetonka, MN 55345
Phone (952) 932-7277

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110511000859 MN Practitioner - Clinical Social Worker 0143406942 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Relate IncGroup PAC ID 8224005491, 22 clinicians

Practice addresses (Care Compare)

5125 County Rd
101 Suite 300
Minnetonka, MN 55345-4157
Phone (952) 932-7277

7700 Equitable Dr
Suite 100
Eden Prairie, MN 55344-3685
Phone (952) 932-7277

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Relate Inc CurrentSince Apr 19, 1999 Accepting new patients

Locations

7700 Equitable Dr
Ste 100
Eden Prairie, MN 55344

5125 County Road 101
Ste 300
Minnetonka, MN 55345
Phone (763) 241-3400

Organizations & group practices 1

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": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760546907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15320 MINNETONKA BLVD",
            "address_2": "#200 RELATE INC",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "55345",
            "telephone_number": "952-932-7277",
            "fax_number": "952-932-9827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15320 MINNETONKA BLVD",
            "address_2": "#200",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "55345",
            "telephone_number": "952-932-7277",
            "fax_number": "952-932-9827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRINDLE",
        "first_name": "DAVID",
        "middle_name": "C",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "4923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minnetonka, MN

Sources for this page

Verify at the official NPI Registry.