Individual provider Active NPI

Adrienne Milligan Platt, CPNP

  • Pediatric Nurse Practitioner
  • Crosslake, MN
National Provider Identifier
1003872540
Registry record updated Sep 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
10170 Issued in MN
Practice address
36974 Bonnie Lakes Rd
Crosslake, MN 56442
Phone
(816) 835-0929
NPI assigned
Apr 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 2002028643 MO
Pediatric Nurse Practitioner 363LP0200X 140607 TX
Pediatric Nurse Practitioner 363LP0200X 10170 MN Primary

Addresses

Primary practice location

36974 Bonnie Lakes Rd
Crosslake, MN 56442

Mailing address

36974 Bonnie Lakes Rd
Crosslake, MN 56442-3109
Phone (816) 835-0929

Other identifiers 1

IdentifierTypeStateIssuer
428969505MedicaidMO

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)
Enrolled
Credentials
Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
10170MNMDPhysician Assistant
2002028643MOMDPediatric Nurse Practitioner
140607TXMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Healthy Kids Consulting LLC Pediatrics CurrentSince Oct 1, 2023 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695859200000",
    "number": "1003872540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36974 BONNIE LAKES RD",
            "city": "CROSSLAKE",
            "state": "MN",
            "postal_code": "564423109",
            "telephone_number": "816-835-0929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36974 BONNIE LAKES RD",
            "city": "CROSSLAKE",
            "state": "MN",
            "postal_code": "56442",
            "telephone_number": "816-835-0929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLATT",
        "first_name": "ADRIENNE",
        "middle_name": "MILLIGAN",
        "name_prefix": "Dr.",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-25",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MO",
            "license": "2002028643",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "140607",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MN",
            "license": "10170",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "428969505",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crosslake, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 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.