Individual provider Active NPI

Danielle Nicole Thurman, CPNP

  • Pediatrics Physician
  • Blaine, MN
National Provider Identifier
1962276964
Registry record updated Nov 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
10967 Issued in MN
Practice address
11107 Ulysses St NE Ste 100
Blaine, MN 55434-4264
Phone
(763) 333-7733
NPI assigned
Nov 9, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 10967 MN Primary

Addresses

Primary practice location

11107 Ulysses St NE Ste 100
Blaine, MN 55434-4264

Mailing address

11107 Ulysses St NE Ste 100
Blaine, MN 55434-4264
Phone (763) 333-7733

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
Credentials
Certified Pediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Child and Teen Medical Center Pediatrics CurrentSince Nov 12, 2023 Accepting new patients

Locations

7225 University Ave NE
Fridley, MN 55432
Phone (763) 236-2150

500 Osborne Rd NE
Ste 310
Fridley, MN 55432
Phone (651) 483-0282

11107 Ulysses St NE
Ste 100
Minneapolis, MN 55434
Phone (763) 333-7723

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": "1699488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699488000000",
    "number": "1962276964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11107 ULYSSES ST NE STE 100",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554344264",
            "telephone_number": "763-333-7733",
            "fax_number": "763-333-7710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11107 ULYSSES ST NE STE 100",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554344264",
            "telephone_number": "763-333-7733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THURMAN",
        "first_name": "DANIELLE",
        "middle_name": "NICOLE",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-09",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "10967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blaine, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2023; 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.