Individual provider Active NPI

Leslie Pratt

  • Maternal & Fetal Medicine Physician
  • St Louis Park, MN
National Provider Identifier
1003891565
Registry record updated Mar 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X
License
24365 Issued in MN
Practice address
3931 Louisiana Ave S
Ste E111
St Louis Park, MN 55426-4375
Phone
(952) 993-5900
Fax
(952) 993-3213
NPI assigned
Dec 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Maternal & Fetal Medicine Physician 207VM0101X 24365 MN Primary

Addresses

Primary practice location

3931 Louisiana Ave S
Ste E111
St Louis Park, MN 55426-4375

Mailing address

3800 Park Nicollet Blvd
Credentialing
St Louis Park, MN 55416-2527

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
24365MNMDMaternal & Fetal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1133913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330992000000",
    "number": "1003891565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 PARK NICOLLET BLVD",
            "address_2": "CREDENTIALING",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554162527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3931 LOUISIANA AVE S",
            "address_2": "STE E111",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554264375",
            "telephone_number": "952-993-5900",
            "fax_number": "952-993-3213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRATT",
        "first_name": "LESLIE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-07",
        "last_updated": "2012-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "MN",
            "license": "24365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Louis Park, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2012; 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.