Active NPI
Lindsay Lee Bragg, M.D.
- Pediatrics Physician
- Woodbury, MN
National Provider Identifier
1679910483
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 60137
- Practice address
- 9680 Tamarack Rd Ste 100
Woodbury, MN 55125-2617 - Phone
- (651) 738-0470
- Fax
- (651) 731-5031
- NPI assigned
- Jun 3, 2013
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 60137 | MN | Primary |
Addresses
Primary practice location
9680 Tamarack Rd Ste 100
Woodbury, MN 55125-2617
Mailing address
9680 Tamarack Rd Ste 100
Woodbury, MN 55125-2617
Phone (651) 738-0470
Other names 1
- Dr. Lindsay Lee Wiesner
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160419000350 | MN | Order and Referring Only - Pediatric Medicine | 3577861947 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60137 | MN | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pediatric Surgical Associates LTD | Past | Accepting new patients | |
| Central Pediatrics, P.a. | 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 and National Provider Directory roles.
-
- Primary Care Clinic/Center
- Woodbury, MN
- NPI 1396721387
-
- Pediatric Surgery Physician
- Minneapolis, MN
- NPI 1093778292
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1370217600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1511913600000",
"number": "1679910483",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9680 TAMARACK RD STE 100",
"city": "WOODBURY",
"state": "MN",
"postal_code": "551252617",
"telephone_number": "651-738-0470",
"fax_number": "651-731-5031"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9680 TAMARACK RD STE 100",
"city": "WOODBURY",
"state": "MN",
"postal_code": "551252617",
"telephone_number": "651-738-0470",
"fax_number": "651-731-5031"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRAGG",
"first_name": "LINDSAY",
"middle_name": "LEE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-06-03",
"last_updated": "2017-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MN",
"license": "60137",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "LINDSAY",
"last_name": "WIESNER",
"middle_name": "LEE",
"prefix": "DR.",
"credential": "M.D.",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Woodbury, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.