Individual provider Active NPI

Teilo Lincoln, HOME MAKER

  • Chore Provider
  • Minneapolis, MN
National Provider Identifier
1942516802
Registry record updated Aug 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Chore ProviderTaxonomy code 372500000X
Practice address
1595 68TH Ave NE
Minneapolis, MN 55432-4714
Phone
(763) 732-9685
NPI assigned
Aug 28, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chore Provider 372500000X MN Primary

Addresses

Primary practice location

1595 68TH Ave NE
Minneapolis, MN 55432-4714

Mailing address

5775 Wayzata Blvd
Suite 700
St Louis Park, MN 55416-1222
Phone (763) 732-9685

Other identifiers 1

IdentifierTypeStateIssuer
348032OtherMNCLASS A PROFESSIONAL HOME HEALTH AGENCY

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1282953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282953600000",
    "number": "1942516802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5775 WAYZATA BLVD",
            "address_2": "SUITE 700",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554161222",
            "telephone_number": "763-732-9685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1595 68TH AVE NE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554324714",
            "telephone_number": "763-732-9685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINCOLN",
        "first_name": "TEILO",
        "credential": "HOME MAKER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-28",
        "last_updated": "2010-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "372500000X",
            "taxonomy_group": "",
            "desc": "Chore Provider",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLASS A PROFESSIONAL HOME HEALTH AGENCY",
            "identifier": "348032",
            "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 28, 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.