Individual provider Active NPI

Lora Meadows

  • Family Nurse Practitioner
  • Plymouth, MN
National Provider Identifier
1205614211
Registry record updated Sep 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
10776 Issued in MN
Practice address
4140 County Road 101 N
Plymouth, MN 55446-2308
Phone
(763) 478-4612
NPI assigned
Sep 20, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 10776 MN Primary

Addresses

Primary practice location

4140 County Road 101 N
Plymouth, MN 55446-2308

Mailing address

19846 Tyler St NW
Elk River, MN 55330-2241
Phone (184) 325-0058

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231116001623 MN Practitioner - Nurse Practitioner 5092162891 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Minuteclinic Diagnostic of Minnesota PAGroup PAC ID 7810289949, 83 clinicians

Practice addresses (Care Compare)

4140 County Rd 101
Plymouth, MN 55446-2308
Phone (866) 389-2727

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic Diagnostic of Minnesota, P.a. Family CurrentSince Oct 12, 2023 Accepting new patients
Minuteclinic Primary Care Minnesota PLLC Family CurrentSince Apr 1, 2025 Accepting new patients

Locations

1500 109th Ave NE
Minneapolis, MN 55449
Phone (763) 354-1000

1010 W Lake St
Minneapolis, MN 55408
Phone (612) 822-1297

4140 County Road 101 N
Plymouth, MN 55446
Phone (763) 478-4612

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

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.

NPI Registry JSON

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

{
    "created_epoch": "1695168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695168000000",
    "number": "1205614211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19846 TYLER ST NW",
            "city": "ELK RIVER",
            "state": "MN",
            "postal_code": "553302241",
            "telephone_number": "184-325-0058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4140 COUNTY ROAD 101 N",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554462308",
            "telephone_number": "763-478-4612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEADOWS",
        "first_name": "LORA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-20",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "10776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MN

Sources for this page

Verify at the official NPI Registry.