Individual provider Active NPI

Taylor Nicole Gilbertson, CNP

  • Family Nurse Practitioner
  • Maple Grove, MN
National Provider Identifier
1881416899
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
12129 Issued in MN
Practice address
9645 Grove Cir N Ste 200
Maple Grove, MN 55369-2684
Phone
(763) 201-8191
NPI assigned
Oct 30, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 12129 MN Primary

Addresses

Primary practice location

9645 Grove Cir N Ste 200
Maple Grove, MN 55369-2684

Mailing address

9645 Grove Cir N Ste 200
Maple Grove, MN 55369-2684
Phone (763) 201-8191

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
I20241202002831 MN Practitioner - Nurse Practitioner 2062947963 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Interventional Spine and Pain Physicians PAGroup PAC ID 2466606264, 42 clinicians

Practice addresses (Care Compare)

9645 Grove Cir N
Suite 200
Maple Grove, MN 55369-2684
Phone (763) 201-8191

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12129MNMDOral & Maxillofacial Surgery (D.M.D.)

Practice roles

OrganizationSpecialtyStatusNew patients
Interventional Spine and Pain Physicians, PA CurrentSince Dec 1, 2024 Accepting new patients

Locations

3000 Hundertmark Rd
Ste 250
Chaska, MN 55318
Phone (507) 625-7246

916 Saint Peter Ave E
Delano, MN 55328
Phone (763) 972-9172

9645 Grove Cir N
Ste 200
Maple Grove, MN 55369
Phone (763) 300-2193

9600 Upland Ln N
Ste 160
Maple Grove, MN 55369

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": "1730246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1881416899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9645 GROVE CIR N STE 200",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553692684",
            "telephone_number": "763-201-8191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9645 GROVE CIR N STE 200",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553692684",
            "telephone_number": "763-201-8191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILBERTSON",
        "first_name": "TAYLOR",
        "middle_name": "NICOLE",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-30",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "12129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maple Grove, MN

Sources for this page

Verify at the official NPI Registry.