Active NPI
Tina Patricia Lavin, SLP
- Speech-Language Pathologist
- St Louis Park, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 6177
- Practice address
- 6500 Excelsior Blvd
Saint Louis Park, MN 55426-4702 - Phone
- (952) 993-1000
- NPI assigned
- Mar 26, 2007
- Last updated
- May 3, 2018
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 6177 | MN | Primary |
Addresses
Primary practice location
6500 Excelsior Blvd
Saint Louis Park, MN 55426-4702
Mailing address
709 University Ave W
Saint Paul, MN 55104-4804
Phone (651) 265-2314
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| HP43893 | Other | MN | HEALTH PARTNERS |
| 4600293 | Other | MN | MEDICA |
| 9G930AS | Other | MN | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Qualified Speech Language Pathologist
- Education
- Other, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
5320 Hyland Greens Dr
Bloomington, MN 55437-3934
Phone (952) 993-2400
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6177 | MN | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Park Nicollet Clinic | Current | Accepting new patients | |
| Park Nicollet Methodist Hospital | Current | Accepting new patients | |
| Park Nicollet Clinic | Current | Accepting new patients | |
| Lifetrack Resources, Inc. | Speech-Language Pathologist | Past | Accepting new patients |
Locations
5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400
6500 Excelsior Blvd
St Louis Park, MN 55426
Phone (952) 993-3246
Organizations & group practices 4
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.
-
- Family Medicine Physician
- St Louis Park, MN
- NPI 1780621904
-
- Family Medicine Physician
- St Louis Park, MN
- NPI 1063897593
-
dba Park Nicollet Methodist Hospital Outpatient Surgery Center
- General Acute Care Hospital
- St Louis Park, MN
- NPI 1194113217
-
- Clinical Child & Adolescent Psychologist
- Saint Paul, MN
- NPI 1225045362
Speech-Language Pathologist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1525305600000",
"number": "1053439497",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "709 UNIVERSITY AVE W",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551044804",
"telephone_number": "651-265-2314",
"fax_number": "651-265-2318"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6500 EXCELSIOR BLVD",
"city": "SAINT LOUIS PARK",
"state": "MN",
"postal_code": "554264702",
"telephone_number": "952-993-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAVIN",
"first_name": "TINA",
"middle_name": "PATRICIA",
"name_prefix": "Mrs.",
"credential": "SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-26",
"last_updated": "2018-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MN",
"license": "6177",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PARTNERS",
"identifier": "HP43893",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA",
"identifier": "4600293",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "9G930AS",
"state": "MN"
}
],
"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 May 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.