RAEANN JO ANDERSON (APRN) – Acute Care Nurse Practitioner, NPI 1124915699

RAEANN JO ANDERSON (APRN) is a healthcare provider. based in Minneapolis, Minnesota. specializing in NURSE PRACTITIONER. They hold the professional credentials APRN. They hold a License No. 116088 (NE). The NPI Number for RAEANN JO ANDERSON (APRN) is 1124915699

Main info

Female
1 Year Of Experience
Accepts Medicare Assignment
Name
RAEANN JO ANDERSON (APRN)
NPI
1124915699
Phone
(402) 483-3333
Address
PO BOX 860879
Enumeration Date
18 June 2025
Last Update Date
23 July 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4024833333
Graduation Year
2025 (1 year ago)
PAC ID
6507367067
Group Practice PAC ID
7911803796
Professional Enrollment ID
I20250827004049
Address ID
NE685061275LI1600XSTXX404
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness85
Years active:0State licenses:1Digital endpointsOther names

2,112 NURSE PRACTITIONER in NE

Provider Addresses for RAEANN JO ANDERSON (APRN)

  • PO BOX 860879

    MINNEAPOLIS, MN 554860879

    Phone: (402) 483-3333

    Type: Mailing

  • 1600 S 48TH ST STE 600

    LINCOLN, NE 685061299

    Phone: (402) 483-3333

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-08-27

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250827004049INurse PractitionerNETBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55486)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7911803796View full group profile
NameSpecialtyState
Physician AssistantNE
Cardiovascular Disease (Cardiology), Internal MedicineNE
Vascular SurgeryNE
Cardiovascular Disease (Cardiology)NE
Internal Medicine, Cardiovascular Disease (Cardiology), Internal Medicine, Advanced Heart Failure And Transplant Cardiology, Cardiovascular Disease (Cardiology)NE
Nurse PractitionerMN
Nurse PractitionerNE
Nurse PractitionerNE
Cardiovascular Disease (Cardiology), Advanced Heart Failure And Transplant Cardiology, Nuclear MedicineNE
Cardiovascular Disease (Cardiology), Internal MedicineNE

Reviews

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Frequently asked questions

Can I use this page to confirm RAEANN JO ANDERSON (APRN)'s NPI?
Yes. RAEANN JO ANDERSON (APRN) is listed with NPI 1124915699 in the public NPI dataset.
Does CMS list RAEANN JO ANDERSON (APRN) as active?
Yes — RAEANN JO ANDERSON (APRN) is active in the NPI listing used on this page.
What taxonomy line describes RAEANN JO ANDERSON (APRN)?
For research purposes, treat RAEANN JO ANDERSON (APRN) as Acute Care Nurse Practitioner in this dataset. Clinical services aligned with this taxonomy classification.
What area does RAEANN JO ANDERSON (APRN) serve?
RAEANN JO ANDERSON (APRN)'s listing highlights Minneapolis, Minnesota; more addresses can appear in NPPES.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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