Carolyn Marie Loudermilk, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

10509 Issued in MN

Practice address

1210 1St St W
Hastings, MN 55033-1147

Phone

(651) 438-1800

NPI assigned

Oct 28, 2008

Last updated

Nov 10, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Allina Health System

  dba Allina Health Buffalo Specialty Clinic

  • Obstetrics & Gynecology Physician
  • Buffalo, MN
  • NPI 1295272342
  Medicare reassignment
• Allina Health System

  dba Allina Health Eagan Clinic

  • Family Medicine Physician
  • Eagan, MN
  • NPI 1780980599
  NPD
• Allina Health System

  dba Allina Health TeleRheumatology

  • Rheumatology Physician
  • Coon Rapids, MN
  • NPI 1952146516
  NPD
• NPI 1083910871

  • NPI 1083910871
  NPD (past)

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

{
    "created_epoch": "1225152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604966400000",
    "number": "1366695066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 1ST ST W",
            "city": "HASTINGS",
            "state": "MN",
            "postal_code": "550331147",
            "telephone_number": "651-438-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 1ST ST W",
            "city": "HASTINGS",
            "state": "MN",
            "postal_code": "550331147",
            "telephone_number": "651-438-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOUDERMILK",
        "first_name": "CAROLYN",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-28",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "10509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cloudermilk271243@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "1210 1st St W",
            "city": "Hastings",
            "state": "MN",
            "country_code": "US",
            "postal_code": "550331147",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Susan Hietala Levahn, PT
• Lionheart Wellness and Recovery
• Marisela Loera
• Ann Catherine Lohmann, DC
• Peggy K Lorentz, MD
• Kristina R. Lund, P.T.
• Wesley Allen Lund, M.A.
• Joanne K Luu
• Michael Charles Luxem, PHD
• Janet C Lynn, AU.D. AUDIOLOGIST

• Physician Assistant in Hastings, MN
• Providers in Hastings, MN by specialty
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.