Individual provider Active NPI

Vicki K Schaefers, CPNP

  • Pediatric Nurse Practitioner
  • Minneapolis, MN
National Provider Identifier
1922072412
Registry record updated Aug 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
R1158155 Issued in MN
Practice address
2525 Chicago Ave S
Childrens Specialty Clinic Hematology Oncology MPLS
Minneapolis, MN 55404
Phone
(612) 813-5940
Fax
(612) 813-6325
NPI assigned
Feb 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2012

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 R1158155 MN Primary

Addresses

Primary practice location

2525 Chicago Ave S
Childrens Specialty Clinic Hematology Oncology MPLS
Minneapolis, MN 55404

Mailing address

2910 Centre Pointe Dr
35-121A Childrens Health Care
Roseville, MN 55113
Phone (651) 855-2109

Other identifiers 1

IdentifierTypeStateIssuer
130828900MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R1158155MNMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Health Care Past Accepting new patients

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": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346025600000",
    "number": "1922072412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2910 CENTRE POINTE DR",
            "address_2": "35-121A CHILDRENS HEALTH CARE",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "55113",
            "telephone_number": "651-855-2109",
            "fax_number": "651-855-2310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 CHICAGO AVE S",
            "address_2": "CHILDRENS SPECIALTY CLINIC HEMATOLOGY ONCOLOGY MPLS",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55404",
            "telephone_number": "612-813-5940",
            "fax_number": "612-813-6325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHAEFERS",
        "first_name": "VICKI",
        "middle_name": "K",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-14",
        "last_updated": "2012-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MN",
            "license": "R1158155",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "130828900",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2012; 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.