Individual provider Active NPI

Brianna Marie Gloe, APRN, CPNP

  • Pediatric Nurse Practitioner
  • Minneapolis, MN
National Provider Identifier
1881207462
Registry record updated Aug 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
2324988 Issued in MN
Practice address
2530 Chicago Ave Ste 550
Minneapolis, MN 55404-4293
Phone
(612) 813-8000
NPI assigned
Aug 25, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 2324988 MN Primary

Addresses

Primary practice location

2530 Chicago Ave Ste 550
Minneapolis, MN 55404-4293

Mailing address

2530 Chicago Ave Ste 550
Minneapolis, MN 55404-4293

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
I20201106000216 MN Practitioner - Nurse Practitioner 4486064284 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2324988MNMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Surgical Associates LTD CurrentSince Aug 31, 2020 Accepting new patients
Gillette Children's Specialty Healthcare PastSince Aug 30, 2020 Accepting new patients

Locations

2530 Chicago Ave
Minneapolis, MN 55404
Phone (612) 813-6000

2530 Chicago Ave
Ste 550
Minneapolis, MN 55404
Phone (612) 810-8000

4530 77th St W
Ste 250
Minneapolis, MN 55435

5354 Edgewood Dr
Saint Paul, MN 55112

347 Smith Ave N
Ste 502
Saint Paul, MN 55102
Phone (651) 248-2113

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": "1598313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598313600000",
    "number": "1881207462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2530 CHICAGO AVE STE 550",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554044293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2530 CHICAGO AVE STE 550",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554044293",
            "telephone_number": "612-813-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLOE",
        "first_name": "BRIANNA",
        "middle_name": "MARIE",
        "credential": "APRN, CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-25",
        "last_updated": "2020-08-25",
        "certification_date": "2020-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MN",
            "license": "2324988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.