Individual provider Active NPI

Lindsay Jan Schwab-Peterson, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Blaine, MN
National Provider Identifier
1659777399
Registry record updated Mar 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
3445 Issued in MN
Practice address
10729 Town Square Dr NE Ste 120
Blaine, MN 55449-7923
Phone
(763) 343-9010
Fax
(763) 343-9011
NPI assigned
Nov 7, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 3445 MN Primary

Addresses

Primary practice location

10729 Town Square Dr NE Ste 120
Blaine, MN 55449-7923

Mailing address

1900 Silver Lake Rd NW
New Brighton, MN 55112-1786
Phone (651) 628-9566

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150401001630 MN Practitioner - Nurse Practitioner 3870810872 Reassigns benefits to 1 organization
I20190923001664 WI Practitioner - Nurse Practitioner 3870810872 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3445MNMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nystrom & Associates, LTD CurrentSince Mar 4, 2024 Accepting new patients
St. Luke'S Hospital of Duluth CurrentSince Jul 15, 2019 Accepting new patients
St. Luke'S Hospital of Duluth Current Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

10729 Town Square Dr NE
Ste 120
Blaine, MN 55449
Phone (763) 200-8248

915 E 1st St
Duluth, MN 55805
Phone (218) 249-5352

1900 Silver Lake Rd NW
Ste 110
Saint Paul, MN 55112
Phone (651) 379-1718

1900 Silver Lake Rd NW
Saint Paul, MN 55112
Phone (651) 379-1704

1615 Maple Ln
Ashland, WI 54806
Phone (715) 682-4563

2201 Lake Shore Dr E
Ashland, WI 54806
Phone (715) 685-6600

Organizations & group practices 3

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": "1415318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710201600000",
    "number": "1659777399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 SILVER LAKE RD NW",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551121786",
            "telephone_number": "651-628-9566",
            "fax_number": "651-628-0411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10729 TOWN SQUARE DR NE STE 120",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554497923",
            "telephone_number": "763-343-9010",
            "fax_number": "763-343-9011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHWAB-PETERSON",
        "first_name": "LINDSAY",
        "middle_name": "JAN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-07",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "3445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blaine, MN

Sources for this page

Verify at the official NPI Registry.