NPIMap

Organization Active NPI

Doctors at Home PC

  • Family Medicine Physician
  • Minnetonka, MN
National Provider Identifier
1841043296
Registry record updated May 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
DOCTORS AT HOME PC
Practice address
12600 Whitewater Dr Ste 125
Minnetonka, MN 55343-4602
Phone
(952) 562-1235
NPI assigned
Apr 8, 2024
Last updated
May 2, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2024

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

Authorized official

Name
Dr. Dana Maxwell Shipp, MDNPI 1699790493
Title
MD
Phone
(760) 525-5635

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

12600 Whitewater Dr Ste 125
Minnetonka, MN 55343-4602

Mailing address

12600 Whitewater Dr Ste 125
Minnetonka, MN 55343-4602
Phone (952) 562-1235

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240529001713 MN Part B Supplier - Clinic/Group Practice 8426490954 Receives reassigned benefits from 7 practitioners
Practice locations: Minnentonka, MN

National Provider Directory

National Provider Directory

Locations

12600 Whitewater Dr
Ste 12
Minnetonka, MN 55343
Phone (952) 562-1235

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1712534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714608000000",
    "number": "1841043296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12600 WHITEWATER DR STE 125",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553434602",
            "telephone_number": "952-562-1235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12600 WHITEWATER DR STE 125",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553434602",
            "telephone_number": "952-562-1235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOCTORS AT HOME PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-08",
        "last_updated": "2024-05-02",
        "certification_date": "2024-05-02",
        "status": "A",
        "authorized_official_last_name": "SHIPP",
        "authorized_official_first_name": "DANA",
        "authorized_official_middle_name": "MAXWELL",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "760-525-5635",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minnetonka, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.