Park Nicollet Health Care Products

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

PARK NICOLLET HEALTH CARE PRODUCTS

Practice address

18432 Kenrick Ave
Lakeville, MN 55044-9288

Phone

(952) 993-8800

NPI assigned

Jun 20, 2011

Reactivated

Feb 20, 2025

Last updated

Feb 20, 2025By the provider in NPPES

Organization subpart

Yes

Parent organization

PARK NICOLLET HEALTH SERVICESAs reported in NPPES

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

Authorized official

Name

Catherine F Lenagh

Title

Cfo

Phone

(952) 993-3108

Specialties & licenses 1

Addresses

Other identifiers 1

Part of

Park Nicollet

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

{
    "created_epoch": "1308528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740009600000",
    "number": "1407142359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 PARK NICOLLET BLVD",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554162527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18432 KENRICK AVE",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550449288",
            "telephone_number": "952-993-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK NICOLLET HEALTH CARE PRODUCTS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PARK NICOLLET HEALTH SERVICES",
        "enumeration_date": "2011-06-20",
        "last_updated": "2025-02-20",
        "deactivation_date": "2025-01-24",
        "reactivation_date": "2025-02-20",
        "status": "A",
        "authorized_official_last_name": "LENAGH",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "952-993-3108"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4464590026",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susan Rae Pacyga, LICSW LMFT
• Marcus C Padilla
• Sara Joanne Pahl, BCBA, LPCC
• Shujin Pang
• Panoramic Perspectives Therapy and Training, PA
• Amy Lynn Parker, MSW, LICSW
• Maria Patch, RN
• Rupa Bharat Patel, PHARM. D.
• Shamoli Patel, MD
• Katherine Ann Patras Legut, L.M.F.T.

• Durable Medical Equipment & Medical Supplies in Lakeville, MN
• Providers in Lakeville, MN by specialty
• Durable Medical Equipment & Medical Supplies in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.