Individual provider Active NPI

Miranda Lee Lakmann, PT, DPT, CSCS

  • Physical Therapist
  • Plymouth, MN
National Provider Identifier
1619717709
Registry record updated Jul 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
13473 Issued in MN
Practice address
14100 Carlson Pkwy Ste 200
Plymouth, MN 55441-5312
Phone
(763) 519-7900
Fax
(763) 450-0202
NPI assigned
May 28, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 13473 MN Primary

Addresses

Primary practice location

14100 Carlson Pkwy Ste 200
Plymouth, MN 55441-5312

Mailing address

1939 Minnehaha Ave W Ste 300
Saint Paul, MN 55104-1033
Phone (651) 748-4338

Other names 1

  • Miranda Lee Overland Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240626001603 MN Practitioner - Physical Therapist in Private Practice 6406390970 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Therapy Partners IncGroup PAC ID 4486552593, 135 clinicians
Fairview Express CareGroup PAC ID 3375645179, 1,946 clinicians

Practice addresses (Care Compare)

14100 Carlson Pkwy
Suite 200
Plymouth, MN 55441-5312
Phone (763) 519-7900

2525 University Ave SE
Minneapolis, MN 55414-3205
Phone (612) 672-6697

2535 University Ave SE
Minneapolis, MN 55414-3205
Phone (612) 672-2350

717 Delaware St SE
Suite 340
Minneapolis, MN 55414-2959
Phone (612) 672-7422

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13473MNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy Partners, Inc. Physical Therapist CurrentSince Sep 2, 2025 Accepting new patients
Therapy Partners Inc Physical Therapist CurrentSince Sep 2, 2025 Accepting new patients
Fairview Express Care Current Accepting new patients
Fairview Express Care CurrentSince Jun 1, 2024 Accepting new patients
Healtheast Outpatient Services, LLC Physical Therapist CurrentSince Jun 1, 2024 Accepting new patients
Fairview Express Care CurrentSince Jun 1, 2024 Accepting new patients

Locations

2525 University Ave SE
Minneapolis, MN 55414
Phone (612) 273-7827

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

14100 Carlson Pkwy
Ste 200
Plymouth, MN 55441
Phone (763) 519-7900

1939 Minnehaha Ave W
Ste 300
Saint Paul, MN 55104

1700 Tower Dr W
Stillwater, MN 55082
Phone (651) 275-4706

1825 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-6700

Organizations & group practices 6

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": "1716854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753747200000",
    "number": "1619717709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1939 MINNEHAHA AVE W STE 300",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551041033",
            "telephone_number": "651-748-4338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14100 CARLSON PKWY STE 200",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554415312",
            "telephone_number": "763-519-7900",
            "fax_number": "763-450-0202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAKMANN",
        "first_name": "MIRANDA",
        "middle_name": "LEE",
        "credential": "PT, DPT, CSCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-28",
        "last_updated": "2025-07-29",
        "certification_date": "2025-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "13473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIRANDA",
            "last_name": "OVERLAND",
            "middle_name": "LEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Plymouth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.