Organization Active NPI

Family Tree Inc

Doing business as Family Tree Clinic

  • Ambulatory Family Planning Facility
  • Minneapolis, MN
National Provider Identifier
1952417412
Registry record updated May 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Family Planning FacilityTaxonomy code 261QA0005X
Legal business name
FAMILY TREE INC
Doing business as
Family Tree Clinic
Practice address
1919 Nicollet Ave
Minneapolis, MN 55403
Phone
(612) 473-0800
NPI assigned
Aug 21, 2006
Last updated
May 13, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2026

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

Authorized official

Name
Willow Nichols
Title
Finance Director
Phone
(612) 473-0812

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Family Planning Facility 261QA0005X Primary

Addresses

Primary practice location

1919 Nicollet Ave
Minneapolis, MN 55403

Mailing address

1919 Nicollet Ave
Minneapolis, MN 55403-3747
Phone (612) 473-0800

Other identifiers 1

IdentifierTypeStateIssuer
645753300MedicaidMN

Other names 1

  • FAMILY TREE CLINIC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031211000106 MN Part B Supplier - Clinic/Group Practice 5799681615 Receives reassigned benefits from 9 practitioners
Practice locations: Minneapolis, MN

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
24D0399071Family Tree Clinic1919 Nicollet Ave, Minneapolis, MN 55403Provider-performed microscopyJul 31, 2026

National Provider Directory

National Provider Directory

Locations

1919 Nicollet Ave
Minneapolis, MN 55403
Phone (612) 445-0225

1619 Dayton Ave
Ste 205
Saint Paul, MN 55104
Phone (651) 645-0478

Practitioners & affiliated clinicians

Practitioners 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778630400000",
    "number": "1952417412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 NICOLLET AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554033747",
            "telephone_number": "612-473-0800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 NICOLLET AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55403",
            "telephone_number": "612-473-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY TREE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-21",
        "last_updated": "2026-05-13",
        "certification_date": "2026-05-13",
        "status": "A",
        "authorized_official_last_name": "NICHOLS",
        "authorized_official_first_name": "WILLOW",
        "authorized_official_title_or_position": "FINANCE DIRECTOR",
        "authorized_official_telephone_number": "612-473-0812"
    },
    "taxonomies": [
        {
            "code": "261QA0005X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Family Planning Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "645753300",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FAMILY TREE CLINIC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "FAMILY TREE CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 May 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.