Megan Stark, NP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

5527 Issued in MN

Practice address

17705 Hutchins Dr Ste 100
Minnetonka, MN 55345-4145

Phone

(952) 401-8300

Fax

(952) 401-8242

NPI assigned

Dec 7, 2015

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• South Lake Clinic, P.a.

  • Pediatrics Physician
  • Minnetonka, MN
  • NPI 1427027184
  NPD (past)

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

{
    "created_epoch": "1449446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636070400000",
    "number": "1154796811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17705 HUTCHINS DR STE 250",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553454103",
            "telephone_number": "952-401-8300",
            "fax_number": "952-401-8242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17705 HUTCHINS DR STE 100",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553454145",
            "telephone_number": "952-401-8300",
            "fax_number": "952-401-8242"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 East St SE Ste 301",
            "address_purpose": "LOCATION",
            "city": "Vienna",
            "state": "VA",
            "postal_code": "221804800",
            "country_code": "US",
            "telephone_number": "703-938-5555 x110",
            "fax_number": "703-319-8580",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STARK",
        "first_name": "MEGAN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-07",
        "last_updated": "2021-11-05",
        "certification_date": "2021-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MN",
            "license": "5527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lori Jayne Stamm
• Jenna Stangland
• Marie Hill Stanley
• Kenneth John Starcznski, DDS
• Kelly Kristine Stark, DDS
• Abigail Mae Starke
• Tamara Wilson Starkey, MSW, LICSW
• Leslie Ann Stasiewski, APNP
• STCH Wayzata MN LLC
• Megan Stearns

• Pediatric Nurse Practitioner in Minnetonka, MN
• Providers in Minnetonka, MN by specialty
• Pediatric Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 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.

Verify at the official NPI Registry.