NPIMap

Individual provider Active NPI

Miranda Lynn Linn, CNP

  • Nurse Practitioner
  • Saint Cloud, MN
National Provider Identifier
1073190245
Registry record updated Mar 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
8096 Issued in MN
Practice address
2025 Stearns Way Ste 114
Saint Cloud, MN 56303-1275
Phone
(320) 656-7195
Fax
(320) 200-3245
NPI assigned
Mar 25, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 8096 MN Primary

Addresses

Primary practice location

2025 Stearns Way Ste 114
Saint Cloud, MN 56303-1275

Mailing address

31736 182ND Ave
Avon, MN 56310-9623
Phone (320) 260-1802

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL linnm@centracare.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210406002004 MN Practitioner - Nurse Practitioner 4486061678 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centracare ClinicGroup PAC ID 2466363395, 800 clinicians

Practice addresses (Care Compare)

3701 12TH S N
Suite 102
Saint Cloud, MN 56303-1275
Phone (320) 656-7195

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Centracare Clinic CurrentSince Mar 24, 2021 Accepting new patients
Centracare Clinic Current Accepting new patients
Centracare Clinic CurrentSince Mar 24, 2021 Accepting new patients

Locations

3701 12th St N
Ste 102
Saint Cloud, MN 56303
Phone (320) 654-8353

2025 Stearns Way
Saint Cloud, MN 56303
Phone (320) 255-7195

1200 6th Ave N
Saint Cloud, MN 56303
Phone (320) 252-3342

2025 Stearns Way
Ste 114
Saint Cloud, MN 56303
Phone (320) 255-7195

Interoperability endpoints

  • Direct secure messaging: mlinn567569@direct.centracare.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1616630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616630400000",
    "number": "1073190245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31736 182ND AVE",
            "city": "AVON",
            "state": "MN",
            "postal_code": "563109623",
            "telephone_number": "320-260-1802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 STEARNS WAY STE 114",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563031275",
            "telephone_number": "320-656-7195",
            "fax_number": "320-200-3245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINN",
        "first_name": "MIRANDA",
        "middle_name": "LYNN",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-25",
        "last_updated": "2021-03-25",
        "certification_date": "2021-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "8096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "linnm@centracare.com",
            "affiliation": "N",
            "endpointDescription": "organization email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "St. Cloud",
            "address_1": "2025 Stearns Way Ste 114",
            "city": "Saint Cloud",
            "state": "MN",
            "country_code": "US",
            "postal_code": "563031275",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Cloud, MN

Sources for this page

Verify at the official NPI Registry.