Active NPI
Nadine Emerson, L.P.
- Psychologist
- Minneapolis, MN
National Provider Identifier
1972714764
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- LP 1041
- Practice address
- 1422 W Lake St
Suite 204
Minneapolis, MN 55408-2616 - Phone
- (612) 822-7135
- NPI assigned
- May 24, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | LP 1041 | MN | Primary |
Addresses
Primary practice location
1422 W Lake St
Suite 204
Minneapolis, MN 55408-2616
Mailing address
1422 W Lake St
Suite 204
Minneapolis, MN 55408-2616
Phone (612) 822-7135
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20171211000022 | MN | Practitioner - Clinical Psychologist | 7618235110 | Practice locations: Minneapolis, MN |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP 1041 | MN | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1972714764",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1422 W LAKE ST",
"address_2": "SUITE 204",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554082616",
"telephone_number": "612-822-7135"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1422 W LAKE ST",
"address_2": "SUITE 204",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554082616",
"telephone_number": "612-822-7135"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EMERSON",
"first_name": "NADINE",
"credential": "L.P.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MN",
"license": "LP 1041",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
- Emerson Adult Day Care Center Inc
- Erin Phaedra Emerson Egginton, DO
- Geoffrey Guy Emerson, MD
- Judith Emerson, LICSW
- Michael Vaughn Emerson, MD
- Erin P Emery, CNP
- Emily Brown Murphrey PSYD LP PLLC
- Emily O Goodridge-Grey Accelerated Charter School
- Emily Oberlander, Ma, LPCC, LLC
- Emily Rischall Price, PSYD LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.