NPIMap

Individual provider Active NPI

Lori A Gutierrez, WHCNP

  • Family Nurse Practitioner
  • Baxter, MN
National Provider Identifier
1295705572
Registry record updated Mar 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3019 Issued in MN
Practice address
13060 Isle Dr
Baxter, MN 56425-8331
Phone
(218) 828-2880
NPI assigned
Jan 26, 2006
Last updated
Mar 9, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3019 MN Primary
Women's Health Nurse Practitioner 363LW0102X R128792-9 MN

Addresses

Primary practice location

13060 Isle Dr
Baxter, MN 56425-8331

Mailing address

523 N 3Rd St
Brainerd, MN 56401-3054
Phone (218) 829-2861

Other identifiers 8

IdentifierTypeStateIssuer
07-01383OtherMEDICA
1025619OtherPREFERRED ONE
345497500MedicaidMN
44526OtherSIOUX VALLEY HEALTH PLAN
140102OtherUCARE
HP31350OtherHEALTH PARTNERS
68G09GUOtherMNBCBS MN
1107621OtherAMERICA'S PPO (ARAZ)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040325001073 MN Practitioner - Nurse Practitioner 5991697989 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brainerd Medical Center IncGroup PAC ID 0648270272, 29 clinicians
St Josephs Medical CenterGroup PAC ID 8224948443, 238 clinicians

Practice addresses (Care Compare)

13060 Isle Dr
Baxter, MN 56425-8331
Phone (218) 454-5935

2024 S 6TH St
Brainerd, MN 56401-4529
Phone (218) 828-2880

523 N 3Rd St
Brainerd, MN 56401-3054
Phone (218) 828-7394

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R128792-9MNMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Brainerd Medical Center Inc Current Accepting new patients
St Joseph's Medical Center CurrentSince Jun 29, 2009 Accepting new patients
St. Joseph's Medical Center CurrentSince Jun 29, 2009 Accepting new patients
Planned Parenthood Minnesota, North Dakota, South Dakota CurrentSince Jan 1, 2004 Accepting new patients
Brainerd Medical Center Inc CurrentSince Jan 2, 2007 Accepting new patients
Brainerd Medical Center Inc. CurrentSince Jan 2, 2007 Accepting new patients
St. Joseph's Medical Center Past Accepting new patients

Locations

13060 Isle Dr
Brainerd, MN 56425
Phone (218) 454-5920

2024 S 6th St
Brainerd, MN 56401
Phone (218) 828-2880

523 N 3rd St
Brainerd, MN 56401
Phone (218) 828-7394

615 Oak St
Brainerd, MN 56401
Phone (218) 454-1546

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

671 Vandalia St
Saint Paul, MN 55114
Phone (651) 696-5674

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646784000000",
    "number": "1295705572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "523 N 3RD ST",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564013054",
            "telephone_number": "218-829-2861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13060 ISLE DR",
            "city": "BAXTER",
            "state": "MN",
            "postal_code": "564258331",
            "telephone_number": "218-828-2880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "LORI",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "WHCNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-26",
        "last_updated": "2022-03-09",
        "certification_date": "2022-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "3019",
            "primary": true
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MN",
            "license": "R128792-9",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "07-01383",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "1025619",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "345497500",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SIOUX VALLEY HEALTH PLAN",
            "identifier": "44526",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "140102",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "HP31350",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MN",
            "identifier": "68G09GU",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICA'S PPO (ARAZ)",
            "identifier": "1107621",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baxter, MN

Sources for this page

Verify at the official NPI Registry.