Individual provider Active NPI

Meredith A Doran, CNP

  • Pediatric Nurse Practitioner
  • Maplewood, MN
National Provider Identifier
1568092161
Registry record updated Oct 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
10663 Issued in MN
Practice address
1965 11TH Ave E Ste 102
Maplewood, MN 55109-5168
Phone
(651) 227-7806
NPI assigned
Jan 22, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 10663 MN Primary

Addresses

Primary practice location

1965 11TH Ave E Ste 102
Maplewood, MN 55109-5168

Mailing address

3500 American Blvd W Ste 300
Bloomington, MN 55431-4442
Phone (952) 512-5600

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
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
10663MNMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Croix Orthopaedics, PA Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1579651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759276800000",
    "number": "1568092161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 AMERICAN BLVD W STE 300",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554314442",
            "telephone_number": "952-512-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1965 11TH AVE E STE 102",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551095168",
            "telephone_number": "651-227-7806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORAN",
        "first_name": "MEREDITH",
        "middle_name": "A",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-22",
        "last_updated": "2025-10-01",
        "certification_date": "2025-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MN",
            "license": "10663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maplewood, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 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.