Active NPI
Tommie Dick Nuesse, MSW, LGSW
- Social Worker
- Randall, MN
National Provider Identifier
1831474048
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 20209
- Practice address
- 27679 Black Forest Pass
Randall, MN 56475-2156 - Phone
- (218) 251-1868
- NPI assigned
- Oct 19, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 20209 | MN | Primary |
| Clinical Social Worker | 1041C0700X | MN | ||
| Addiction (Substance Use Disorder) Counselor | 101YA0400X |
Addresses
Primary practice location
27679 Black Forest Pass
Randall, MN 56475-2156
Mailing address
27679 Black Forest Pass
Randall, MN 56475-2156
Phone (218) 251-1868
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
| License | State | Type | Specialty |
|---|---|---|---|
| 20209 | MN | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1318982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1328227200000",
"number": "1831474048",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27679 BLACK FOREST PASS",
"city": "RANDALL",
"state": "MN",
"postal_code": "564752156",
"telephone_number": "218-251-1868"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "27679 BLACK FOREST PASS",
"city": "RANDALL",
"state": "MN",
"postal_code": "564752156",
"telephone_number": "218-251-1868"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NUESSE",
"first_name": "TOMMIE",
"middle_name": "DICK",
"credential": "MSW, LGSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-10-19",
"last_updated": "2012-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MN",
"license": "20209",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MN",
"license": null,
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Randall, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.