Collaborative Care Consultants LLC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

Legal business name

COLLABORATIVE CARE CONSULTANTS LLC

Practice address

1057 Grand Ave FL 2
Saint Paul, MN 55105-3002

Phone

(651) 384-1736

Fax

(651) 666-1507

NPI assigned

Feb 20, 2025

Organization subpart

No

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

Authorized official

Name

Gretchen MoenNPI 1922034933

Title

Owner

Phone

(651) 485-3923

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gretchen A Moen, DNP, APRN, CPNP

  • Pediatric Nurse Practitioner
  • Saint Paul, MN
  • NPI 1922034933

  Pediatrics

  NPD Authorized official

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

{
    "created_epoch": "1740009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752796800000",
    "number": "1972309987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4734 WESTMINSTER CIR",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551222756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1057 GRAND AVE FL 2",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551053002",
            "telephone_number": "651-384-1736",
            "fax_number": "651-666-1507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLABORATIVE CARE CONSULTANTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-20",
        "last_updated": "2025-07-18",
        "certification_date": "2025-07-18",
        "status": "A",
        "authorized_official_last_name": "MOEN",
        "authorized_official_first_name": "GRETCHEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "651-485-3923"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Michael Coleman, M.D.
• Kassia Coleman, LICSW
• Kim Coleman
• William John Coleman
• Michaelene Colestock, LADC, LPCC
• Mildred Collazo, DDS
• College Prep Elementary
• Collegiate Mental Wellness PLLC
• Amanda Borde Collier, MSW, BA
• Rachel Carolyn Collier, DPM

• Pediatric Nurse Practitioner in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Pediatric Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2025; 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.