Individual provider Active NPI

Debra Solomon, NP

  • Family Nurse Practitioner
  • Edina, MN
National Provider Identifier
1881683175
Registry record updated Apr 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
104203 8 Issued in MN
Practice address
3400 W 66TH St Ste 290
Edina, MN 55435-2133
Phone
(612) 791-3647
Fax
(888) 972-4078
NPI assigned
Oct 19, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2018

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 104203 8 MN Primary

Addresses

Primary practice location

3400 W 66TH St Ste 290
Edina, MN 55435-2133

Mailing address

3400 W 66TH St Ste 290
Edina, MN 55435-2133
Phone (612) 791-3647

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
I20141014001504 MN Practitioner - Nurse Practitioner 8820219934 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2092MNMDSocial Worker
104203 8MNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Clinics Current Accepting new patients
Fairview Health Services Current Accepting new patients
Fairview Clinics CurrentSince Jan 1, 2014 Accepting new patients
Fairview Clinics CurrentSince May 30, 2017 Accepting new patients
Fairview Clinics CurrentSince May 30, 2017 Accepting new patients
Fairview Health Services CurrentSince Jan 1, 2014 Accepting new patients

Locations

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

400 Stinson Blvd
#2
Minneapolis, MN 55413
Phone (612) 672-2294

3400 W 66th St
Ste 290
Minneapolis, MN 55435
Phone (952) 836-3637

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

Interoperability endpoints

  • Direct secure messaging: dsolomon32304@fairview.direct-ci.com

Organizations & group practices 7

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": "1129680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523491200000",
    "number": "1881683175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 W 66TH ST STE 290",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352133",
            "telephone_number": "612-791-3647",
            "fax_number": "888-972-4078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 W 66TH ST STE 290",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352133",
            "telephone_number": "612-791-3647",
            "fax_number": "888-972-4078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOLOMON",
        "first_name": "DEBRA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-19",
        "last_updated": "2018-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "104203 8",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

Verify at the official NPI Registry.