Active NPI
Lisa Elaine Hurt
- Registered Nurse
- New Hope, MN
National Provider Identifier
1467036533
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- R965543
- Practice address
- 7932 27TH Ave N
New Hope, MN 55427-3401 - Phone
- (763) 544-3338
- NPI assigned
- May 5, 2021
- Last updated
- May 5, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | R965543 | MN | Primary |
Addresses
Primary practice location
7932 27TH Ave N
New Hope, MN 55427-3401
Mailing address
1601 W Medicine Lake Dr
Plymouth, MN 55441-4108
Phone (612) 418-3135
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R965543 | MN | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grand St Paul CVS LLC | Past | Accepting new patients | |
| Grand St. Paul CVS LLC | Past | Accepting new patients |
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1620172800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620172800000",
"number": "1467036533",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1601 W MEDICINE LAKE DR",
"city": "PLYMOUTH",
"state": "MN",
"postal_code": "554414108",
"telephone_number": "612-418-3135"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7932 27TH AVE N",
"city": "NEW HOPE",
"state": "MN",
"postal_code": "554273401",
"telephone_number": "763-544-3338"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HURT",
"first_name": "LISA",
"middle_name": "ELAINE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-05-05",
"last_updated": "2021-05-05",
"certification_date": "2021-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MN",
"license": "R965543",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Hope, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.