New Leaf Centers PLLC

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

1336125111 Issued in MN

Legal business name

NEW LEAF CENTERS PLLC

Practice address

5000 W 36TH St Ste 205
St Louis Park, MN 55416-2760

Phone

(952) 807-0415

Fax

(952) 426-3032

NPI assigned

Jan 2, 2014

Organization subpart

No

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

Authorized official

Name

Cheryl Landwehr

Title

Manager

Phone

(952) 801-0415

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1388620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1388620800000",
    "number": "1689095051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 W 36TH ST STE 205",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554162760",
            "telephone_number": "952-807-0415",
            "fax_number": "952-426-3032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 W 36TH ST STE 205",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554162760",
            "telephone_number": "952-807-0415",
            "fax_number": "952-426-3032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW LEAF CENTERS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-02",
        "last_updated": "2014-01-02",
        "status": "A",
        "authorized_official_last_name": "LANDWEHR",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "952-801-0415"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MN",
            "license": "1336125111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2014; 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.