Individual provider Active NPI

Lori Randol Arnesen, M.D.

  • Dermatology Physician
  • Woodbury, MN
National Provider Identifier
1194834796
Registry record updated Mar 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
36219 Issued in MN
Practice address
587 Bielenberg Dr
Suite 200
Woodbury, MN 55125-4451
Phone
(651) 578-2700
Fax
(651) 578-7077
NPI assigned
Aug 29, 2006
Reactivated
Mar 28, 2014
Last updated
Mar 28, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 36219 MN Primary

Addresses

Primary practice location

587 Bielenberg Dr
Suite 200
Woodbury, MN 55125-4451

Mailing address

60 Plato Blvd E
Suite 270
Saint Paul, MN 55107-1827
Phone (651) 209-1600

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
36219MNMDDermatology Physician

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395964800000",
    "number": "1194834796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 PLATO BLVD E",
            "address_2": "SUITE 270",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551071827",
            "telephone_number": "651-209-1600",
            "fax_number": "651-291-9169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "587 BIELENBERG DR",
            "address_2": "SUITE 200",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551254451",
            "telephone_number": "651-578-2700",
            "fax_number": "651-578-7077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARNESEN",
        "first_name": "LORI",
        "middle_name": "RANDOL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-29",
        "last_updated": "2014-03-28",
        "deactivation_date": "2014-01-28",
        "reactivation_date": "2014-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MN",
            "license": "36219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2014; 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.