Individual provider Active NPI

Lori Jean Sussman, NP

  • Neonatal Nurse Practitioner
  • Minneapolis, MN
National Provider Identifier
1285800631
Registry record updated Oct 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
License
7041 Issued in MN
Practice address
800 E 28TH St
Minneapolis, MN 55407
Phone
(612) 863-4000
NPI assigned
May 6, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X COANP04616 OH
Neonatal Nurse Practitioner 363LN0000X APRN.CNP.04616 OH
Critical Care Neonatal Nurse Practitioner 363LN0005X SUS104286507 OH
Neonatal Nurse Practitioner 363LN0000X 7041 MN Primary

Addresses

Primary practice location

800 E 28TH St
Minneapolis, MN 55407

Mailing address

800 E 28TH St
Minneapolis, MN 55407-3723
Phone (612) 863-4000

Other practice location 1

1 Medical Village Dr
Edgewood, KY 41017-3403
Phone (859) 301-2423

Other practice location 2

1 Medical Village Dr
Edgewood, KY 41017-3403
Phone (859) 301-2423

Other names 1

  • Ms. Lori Trinity Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
COANP04616OHMDNurse Practitioner
APRN.CNP.04616OHMDNeonatal Nurse Practitioner
SUS104286507OHMDCritical Care Neonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Francis Regional Medical Center CurrentSince Dec 16, 2019 Accepting new patients
St Francis Regional Medical Center CurrentSince Dec 16, 2019 Accepting new patients

Locations

265 Creek Ln S
Jordan, MN 55352
Phone (952) 428-1200

1455 Saint Francis Ave
Shakopee, MN 55379
Phone (952) 403-2200

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": "1210032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572307200000",
    "number": "1285800631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 E 28TH ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554073723",
            "telephone_number": "612-863-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E 28TH ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55407",
            "telephone_number": "612-863-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Medical Village Dr",
            "address_purpose": "LOCATION",
            "city": "Edgewood",
            "state": "KY",
            "postal_code": "410173403",
            "country_code": "US",
            "telephone_number": "859-301-2423",
            "fax_number": "859-301-2066",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Medical Village Dr",
            "address_purpose": "LOCATION",
            "city": "Edgewood",
            "state": "KY",
            "postal_code": "410173403",
            "country_code": "US",
            "telephone_number": "859-301-2423",
            "fax_number": "859-301-2066",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUSSMAN",
        "first_name": "LORI",
        "middle_name": "JEAN",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-06",
        "last_updated": "2019-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "COANP04616",
            "primary": false
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "OH",
            "license": "APRN.CNP.04616",
            "primary": false
        },
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "OH",
            "license": "SUS104286507",
            "primary": false
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "MN",
            "license": "7041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LORI",
            "last_name": "TRINITY",
            "prefix": "MS.",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.