Individual provider Active NPI

Libbie Tuthill

  • Pediatric Nurse Practitioner
  • Saint Paul, MN
National Provider Identifier
1932520400
Registry record updated Feb 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
R210239-1 Issued in MN
Practice address
347 Smith Ave N
Suite 404
Saint Paul, MN 55102-2387
Phone
(651) 220-6073
Fax
(651) 220-6064
NPI assigned
Dec 30, 2013
Last updated
Feb 26, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2015

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 R210239-1 MN Primary

Addresses

Primary practice location

347 Smith Ave N
Suite 404
Saint Paul, MN 55102-2387

Mailing address

347 Smith Ave N
Suite 404
Saint Paul, MN 55102-2387
Phone (651) 220-6073

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
I20150218001470 MN Practitioner - Nurse Practitioner 6305161118 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Colorado School of Medicine, Denver, 2012
Medicare assignment
May accept Medicare assignment
Group practices
Children's Health CareGroup PAC ID 2668370966, 76 clinicians

Practice addresses (Care Compare)

2525 Chicago Ave
Minneapolis, MN 55404-4518
Phone (612) 813-6273

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R210239-1MNMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Health Care CurrentSince Aug 13, 2014 Accepting new patients
Childrens Health Care CurrentSince Aug 13, 2014 Accepting new patients
Childrens Health Care Current Accepting new patients

Locations

7767 Elm Creek Blvd N
Maple Grove, MN 55369
Phone (612) 813-6000

2525 Chicago Ave
Minneapolis, MN 55404
Phone (612) 813-6000

6060 Clearwater Dr
Ste 220
Minnetonka, MN 55343
Phone (651) 220-6624

5901 Lincoln Dr
#2
Saint Louis Park, MN 55436
Phone (952) 992-5691

345 Smith Ave N
Saint Paul, MN 55102
Phone (651) 220-6000

347 Smith Ave N
Saint Paul, MN 55102
Phone (651) 220-6000

347 Smith Ave N
Ste 404
Saint Paul, MN 55102
Phone (651) 220-6624

628 Bielenberg Dr
Woodbury, MN 55125
Phone (612) 874-1292

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1388361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424908800000",
    "number": "1932520400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "347 SMITH AVE N",
            "address_2": "SUITE 404",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551022387",
            "telephone_number": "651-220-6073",
            "fax_number": "651-220-6064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "347 SMITH AVE N",
            "address_2": "SUITE 404",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551022387",
            "telephone_number": "651-220-6073",
            "fax_number": "651-220-6064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUTHILL",
        "first_name": "LIBBIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-30",
        "last_updated": "2015-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MN",
            "license": "R210239-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.