Organization Active NPI

Evelyn Nerenberg

  • Clinical Social Worker
  • Edina, MN
National Provider Identifier
1962800169
Registry record updated Dec 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
H01471050090001 Issued in MN
Legal business name
EVELYN NERENBERG
Practice address
5780 Lincoln Dr
Suite 124
Edina, MN 55436-1640
Phone
(952) 935-3472
NPI assigned
Dec 21, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2014

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

Authorized official

Name
Janet M Schultz
Title
Medical Biller
Phone
(952) 224-1905

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X H01471050090001 MN Primary

Addresses

Primary practice location

5780 Lincoln Dr
Suite 124
Edina, MN 55436-1640

Mailing address

5780 Lincoln Dr
Suite 124
Edina, MN 55436-1640
Phone (952) 935-3472

National Provider Directory

National Provider Directory

Locations

5780 Lincoln Dr
Ste 124
Edina, MN 55436
Phone (952) 831-9111

NPI Registry JSON

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

{
    "created_epoch": "1419120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419120000000",
    "number": "1962800169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5780 LINCOLN DR",
            "address_2": "SUITE 124",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554361640",
            "telephone_number": "952-935-3472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5780 LINCOLN DR",
            "address_2": "SUITE 124",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554361640",
            "telephone_number": "952-935-3472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVELYN NERENBERG",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-21",
        "last_updated": "2014-12-21",
        "status": "A",
        "authorized_official_last_name": "SCHULTZ",
        "authorized_official_first_name": "JANET",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MEDICAL BILLER",
        "authorized_official_telephone_number": "952-224-1905"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "H01471050090001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2014; 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.