NPIMap

Organization Active NPI

Two Rivers Lung Specialists, P. a.

  • Pulmonary Disease Physician
  • Coon Rapids, MN
National Provider Identifier
1902839947
Registry record updated Jan 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
1564 Issued in MN
Legal business name
TWO RIVERS LUNG SPECIALISTS, P. A.
Practice address
4040 Coon Rapids Blvd NW
Suite #100
Coon Rapids, MN 55433-2522
Phone
(763) 236-9494
Fax
(763) 236-9495
NPI assigned
Jul 9, 2006
Last updated
Jan 26, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2010

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

Authorized official

Name
Dr. Jeanne M Nelson, M. D.NPI 1457411175
Title
President/Owner
Phone
(763) 236-9494

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RP1001X 1564 MN Primary

Addresses

Primary practice location

4040 Coon Rapids Blvd NW
Suite #100
Coon Rapids, MN 55433-2522

Mailing address

4040 Coon Rapids Blvd NW
Suite #100
Coon Rapids, MN 55433-2522
Phone (763) 236-9494

Other identifiers 6

IdentifierTypeStateIssuer
83654OtherMNHEALTH PART
CJ7024OtherMNRAILROAD MEDICARE
142464OtherMNUCARE
0001OtherMNMEDICA
193J9TWOtherMNBCBS OF MN
788700100MedicaidMN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264464000000",
    "number": "1902839947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4040 COON RAPIDS BLVD NW",
            "address_2": "SUITE #100",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554332522",
            "telephone_number": "763-236-9494",
            "fax_number": "763-236-9495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4040 COON RAPIDS BLVD NW",
            "address_2": "SUITE #100",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554332522",
            "telephone_number": "763-236-9494",
            "fax_number": "763-236-9495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TWO RIVERS LUNG SPECIALISTS, P. A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "last_updated": "2010-01-26",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "JEANNE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "763-236-9494",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M. D."
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MN",
            "license": "1564",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PART",
            "identifier": "83654",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CJ7024",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "142464",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "0001",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MN",
            "identifier": "193J9TW",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "788700100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coon Rapids, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.