Individual provider Active NPI

Donald Victor Lugg

  • Gerontology Nurse Practitioner
  • Minneapolis, MN
National Provider Identifier
1396657797
Registry record updated Sep 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
14841 Issued in MN
Practice address
5716 Wentworth Ave
Minneapolis, MN 55419-1817
Phone
(952) 451-5946
NPI assigned
Sep 21, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 14841 MN Primary

Addresses

Primary practice location

5716 Wentworth Ave
Minneapolis, MN 55419-1817

Mailing address

5716 Wentworth Ave
Minneapolis, MN 55419-1817
Phone (952) 451-5946

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1789948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789948800000",
    "number": "1396657797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5716 WENTWORTH AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554191817",
            "telephone_number": "952-451-5946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5716 WENTWORTH AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554191817",
            "telephone_number": "952-451-5946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUGG",
        "first_name": "DONALD",
        "middle_name": "VICTOR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-09-21",
        "last_updated": "2026-09-21",
        "certification_date": "2026-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MN",
            "license": "14841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.