Elizabeth A Liljeblad, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

32718 Issued in MN

Practice address

4190 Loberg Ave
Hermantown, MN 55811-2652

Phone

(218) 249-4600

Fax

(218) 249-4666

NPI assigned

May 10, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: elizabeth.liljeblad@slk.direct.slhduluth.com

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.

• St. Luke'S Hospital of Duluth

  • General Acute Care Hospital
  • Duluth, MN
  • NPI 1801835970
  NPD
• Firstsolutions

  • Community/Retail Pharmacy
  • Two Harbors, MN
  • NPI 1780600759
  NPD (past)
• Residential Services of NE MN Inc.

  • Mental Health Counselor
  • Duluth, MN
  • NPI 1821150236
  NPD (past)

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485475200000",
    "number": "1104875632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4190 LOBERG AVE",
            "city": "HERMANTOWN",
            "state": "MN",
            "postal_code": "558112652",
            "telephone_number": "218-249-4600",
            "fax_number": "218-249-4666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4190 LOBERG AVE",
            "city": "HERMANTOWN",
            "state": "MN",
            "postal_code": "558112652",
            "telephone_number": "218-249-4600",
            "fax_number": "218-249-4666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LILJEBLAD",
        "first_name": "ELIZABETH",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-10",
        "last_updated": "2017-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "32718",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "933297900",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "P00082385",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jayci Kay Lee
• Rebecca Marie-Lewis Lee, PT
• Wing Ki Lee
• Rebecca Rae Lemke, RBT
• Molly Elizabeth Lenmark
• Julie Lind
• Peyton Sophia Lind
• Eden Joy Lindmeier
• Olivia Rose Lopac
• Carrie Lynn Lott-Grambush, APRN, CNP

• All providers in Hermantown, MN
• Family Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2017; 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.