Active NPI
Lisa Ann Miles, CNP
- Psychiatric/Mental Health Nurse Practitioner
- Minneapolis, MN
National Provider Identifier
1093741886
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 3654
- Practice address
- 2900 Thomas Ave S Ste 100
Minneapolis, MN 55416 - Phone
- (612) 979-2276
- NPI assigned
- Jun 23, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Registered Nurse | 163WG0000X | R125294-1 | MN | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 3654 | MN | Primary |
Addresses
Primary practice location
2900 Thomas Ave S Ste 100
Minneapolis, MN 55416
Mailing address
4301 Elliot Ave
Minneapolis, MN 55407-3156
Phone (512) 708-7562
Other practice location 1
2900 Thomas Ave S
apt 1511
Minneapolis, MN 55416-4477
Phone (612) 708-7562
Other practice location 2
4301 Elliot Ave
Minneapolis, MN 55407-3156
Phone (612) 708-7562
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093741886 | Other | MN | PATIENT CHOICE |
| 107D0MI | Other | MN | BCBS |
| 1093741886 | Other | MN | MEDICA |
| 1093741886 | Other | MN | PREFERRED ONE |
| HP 23925 | Other | MN | HEALTHPARTNERS |
| 1093741886 | Other | MN | PCHP |
| 500008053 | Medicaid | MN |
Other names 1
- Lisa Ann Herschlip
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 Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R125294-1 | MN | MD | General Practice Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Miles Med Management Service Corporation | Psychiatric/Mental Health | Current | Accepting new patients |
| Fairview Clinics | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Psychiatric/Mental Health Nurse Practitioner
- Saint Louis Park, MN
- NPI 1225703705
-
- Primary Care Clinic/Center
- Saint Paul, MN
- NPI 1396552147
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151020800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1628899200000",
"number": "1093741886",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4301 ELLIOT AVE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554073156",
"telephone_number": "512-708-7562"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2900 THOMAS AVE S STE 100",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "55416",
"telephone_number": "612-979-2276"
}
],
"practiceLocations": [
{
"address_1": "2900 Thomas Ave S",
"address_2": "apt 1511",
"address_purpose": "LOCATION",
"city": "Minneapolis",
"state": "MN",
"postal_code": "554164477",
"country_code": "US",
"telephone_number": "612-708-7562",
"fax_number": "651-379-3111",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4301 Elliot Ave",
"address_purpose": "LOCATION",
"city": "Minneapolis",
"state": "MN",
"postal_code": "554073156",
"country_code": "US",
"telephone_number": "612-708-7562",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MILES",
"first_name": "LISA",
"middle_name": "ANN",
"credential": "CNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-23",
"last_updated": "2021-08-14",
"certification_date": "2021-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "163WG0000X",
"taxonomy_group": "",
"desc": "Registered Nurse, General Practice",
"state": "MN",
"license": "R125294-1",
"primary": false
},
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "MN",
"license": "3654",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PATIENT CHOICE",
"identifier": "1093741886",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "107D0MI",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA",
"identifier": "1093741886",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED ONE",
"identifier": "1093741886",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHPARTNERS",
"identifier": "HP 23925",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PCHP",
"identifier": "1093741886",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "500008053",
"state": "MN"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "LISA",
"last_name": "HERSCHLIP",
"middle_name": "ANN",
"credential": "NURES PRACTITIONER",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.