NPIMap

Organization Active NPI

Lifespark Medical Group, PA

  • Adult Health Nurse Practitioner
  • St Louis Park, MN
National Provider Identifier
1437930278
Registry record updated Oct 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
Legal business name
LIFESPARK MEDICAL GROUP, PA
Practice address
5320 W 23Rd St Ste 130
St Louis Park, MN 55416-1670
Phone
(952) 345-3310
Fax
(952) 345-8771
NPI assigned
Oct 9, 2023
Organization subpart
Yes
Parent organization
-As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 9, 2023

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

Authorized official

Name
Catherine Ann LauringNPI 1982692232
Title
Vice President
Phone
(952) 345-3213

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QA0505X
Adult Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LA2200X Primary

Addresses

Primary practice location

5320 W 23Rd St Ste 130
St Louis Park, MN 55416-1670

Mailing address

5320 W 23Rd St Ste 130
St Louis Park, MN 55416-1670
Phone (523) 453-3109

Other names 1

  • Lifespark Medical Group Doing business as

National Provider Directory

National Provider Directory
Part of
Lifespark Medical Group PA

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1696809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696809600000",
    "number": "1437930278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5320 W 23RD ST STE 130",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554161670",
            "telephone_number": "523-453-3109",
            "fax_number": "952-345-8771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5320 W 23RD ST STE 130",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554161670",
            "telephone_number": "952-345-3310",
            "fax_number": "952-345-8771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESPARK MEDICAL GROUP, PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "-",
        "enumeration_date": "2023-10-09",
        "last_updated": "2023-10-09",
        "certification_date": "2023-10-09",
        "status": "A",
        "authorized_official_last_name": "LAURING",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "952-345-3213"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lifespark Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in St Louis Park, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2023; 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.