Individual provider Active NPI

Lisa Renee Moorhouse, CPNP

  • Pediatric Nurse Practitioner
  • Little Falls, MN
National Provider Identifier
1326592361
Registry record updated Jan 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
CNP 4388 Issued in MN
Practice address
811 2ND St SE
Little Falls, MN 56345-3559
Phone
(320) 631-7200
Fax
(320) 632-0534
NPI assigned
Aug 8, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X CNP 4388 MN Primary

Addresses

Primary practice location

811 2ND St SE
Little Falls, MN 56345-3559

Mailing address

811 2ND St SE
Little Falls, MN 56345-3559
Phone (320) 631-7200

Other practice location 1

3850 Park Nicollet Blvd
St Louis Park, MN 55416-2527
Phone (952) 883-1000

Other practice location 2

13060 Isle Dr
Baxter, MN 56425-8331
Phone (218) 828-2880

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
I20161104001814 MN Practitioner - Nurse Practitioner 1052699485 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Unity Family Healthcare CurrentSince Jan 7, 2021 Accepting new patients
Unity Family Healthcare CurrentSince Jan 7, 2021 Accepting new patients
Unity Family Healthcare Current Accepting new patients
Unity Family Healthcare Current Accepting new patients
Lake Region Healthcare Corporation Current Accepting new patients
Lake Region Healthcare Corporation CurrentSince Oct 1, 2023 Accepting new patients

Locations

7892 Solutions Ctr
Chicago, IL 60677

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

712 S Cascade St
Fergus Falls, MN 56537

815 2nd St SE
Little Falls, MN 56345
Phone (320) 632-5441

811 2nd St SE
Little Falls, MN 56345
Phone (320) 631-7000

200 1st Ave SE
Pierz, MN 56364
Phone (320) 468-2536

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/e35355ac-dfca-48b9-9dd9-0b7c408c2a66/

Organizations & group practices 6

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": "1470614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610668800000",
    "number": "1326592361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 2ND ST SE",
            "city": "LITTLE FALLS",
            "state": "MN",
            "postal_code": "563453559",
            "telephone_number": "320-631-7200",
            "fax_number": "320-632-0534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 2ND ST SE",
            "city": "LITTLE FALLS",
            "state": "MN",
            "postal_code": "563453559",
            "telephone_number": "320-631-7200",
            "fax_number": "320-632-0534"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3850 Park Nicollet Blvd",
            "address_purpose": "LOCATION",
            "city": "St Louis Park",
            "state": "MN",
            "postal_code": "554162527",
            "country_code": "US",
            "telephone_number": "952-883-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13060 Isle Dr",
            "address_purpose": "LOCATION",
            "city": "Baxter",
            "state": "MN",
            "postal_code": "564258331",
            "country_code": "US",
            "telephone_number": "218-828-2880",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORHOUSE",
        "first_name": "LISA",
        "middle_name": "RENEE",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-08",
        "last_updated": "2021-01-15",
        "certification_date": "2021-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MN",
            "license": "CNP 4388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Falls, MN

Sources for this page

Verify at the official NPI Registry.