Active NPI
Lauren Kennerly
- Adult Health Nurse Practitioner
- Eagan, MN
National Provider Identifier
1699376996
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- APRN-NP335780
- Practice address
- PO Box 211699
Eagan, MN 55121-3699 - Phone
- (866) 849-0692
- Fax
- (888) 973-8821
- NPI assigned
- Nov 3, 2020
- 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 15
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | C-APN.0106154-C-NP | CO | |
| Adult Health Nurse Practitioner | 363LA2200X | APRN11045621 | FL | |
| Adult Health Nurse Practitioner | 363LA2200X | 5024485 | NC | |
| Registered Nurse | 163W00000X | 041425398 | IL | |
| Adult Health Nurse Practitioner | 363LA2200X | 3-002805 | AL | |
| Adult Health Nurse Practitioner | 363LA2200X | 237988 | AR | |
| Adult Health Nurse Practitioner | 363LA2200X | 31849 | SC | |
| Primary Care Nurse Practitioner | 363LP2300X | 95017524 | CA | |
| Adult Health Nurse Practitioner | 363LA2200X | 0028862 | OH | |
| Adult Health Nurse Practitioner | 363LA2200X | 1231287 | TX | |
| Adult Health Nurse Practitioner | 363LA2200X | SP035463 | PA | |
| Adult Health Nurse Practitioner | 363LA2200X | H189520 | IA | |
| Adult Health Nurse Practitioner | 363LA2200X | 908237 | MS | |
| Adult Health Nurse Practitioner | 363LA2200X | APRN-NP335780 | GA | Primary |
| Adult Health Nurse Practitioner | 363LA2200X | 2026009163 | MO |
Addresses
Primary practice location
PO Box 211699
Eagan, MN 55121-3699
Mailing address
PO Box 211699
Eagan, MN 55121-3699
Phone (866) 849-0692
Other practice location 1
50 Alessandro Pl Ste A20
Pasadena, CA 91105-3149
Phone (800) 851-0966
Other practice location 2
1611 W Harrison St
Chicago, IL 60612-4861
Phone (312) 432-2472
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231005003483 | GA | Practitioner - Nurse Practitioner | 3375998685 |
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
PO Box
Atlanta, GA 30374
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 041425398 | IL | MD | Registered Nurse |
| 3-002805 | AL | MD | Adult Health Nurse Practitioner |
| C-APN.0106154-C-NP | CO | MD | Adult Health Nurse Practitioner |
| APRN11045621 | FL | MD | Adult Health Nurse Practitioner |
| APRN-NP335780 | GA | MD | Adult Health Nurse Practitioner |
| H189520 | IA | MD | Adult Health Nurse Practitioner |
| 2026009163 | MO | MD | Adult Health Nurse Practitioner |
| 908237 | MS | MD | Adult Health Nurse Practitioner |
| 5024485 | NC | MD | Adult Health Nurse Practitioner |
| 0028862 | OH | MD | Adult Health Nurse Practitioner |
| SP035463 | PA | MD | Adult Health Nurse Practitioner |
| 1231287 | TX | MD | Adult Health Nurse Practitioner |
| 95017524 | CA | MD | Primary Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Devoted Medical Group Professional Corporation | Current | Accepting new patients | |
| Pacific Pace, LLC | Past | Accepting new patients |
Interoperability endpoints
- https://api.platform.athenahealth.com/17371/brand/1/csg/1/fhir/r4
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
- Pembroke Pines, FL
- NPI 1245838168
-
- PACE Provider Organization
- Pasadena, CA
- NPI 1194202697
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1604361600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1782086400000",
"number": "1699376996",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 211699",
"city": "EAGAN",
"state": "MN",
"postal_code": "551213699",
"telephone_number": "866-849-0692",
"fax_number": "888-973-8821"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "PO BOX 211699",
"city": "EAGAN",
"state": "MN",
"postal_code": "551213699",
"telephone_number": "866-849-0692",
"fax_number": "888-973-8821"
}
],
"practiceLocations": [
{
"address_1": "50 Alessandro Pl Ste A20",
"address_purpose": "LOCATION",
"city": "Pasadena",
"state": "CA",
"postal_code": "911053149",
"country_code": "US",
"telephone_number": "800-851-0966",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1611 W Harrison St",
"address_purpose": "LOCATION",
"city": "Chicago",
"state": "IL",
"postal_code": "606124861",
"country_code": "US",
"telephone_number": "312-432-2472",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KENNERLY",
"first_name": "LAUREN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-11-03",
"last_updated": "2026-06-22",
"certification_date": "2026-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "CO",
"license": "C-APN.0106154-C-NP",
"primary": false
},
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "FL",
"license": "APRN11045621",
"primary": false
},
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "NC",
"license": "5024485",
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "IL",
"license": "041425398",
"primary": false
},
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "AL",
"license": "3-002805",
"primary": false
},
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "AR",
"license": "237988",
"primary": false
},
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "SC",
"license": "31849",
"primary": false
},
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "CA",
"license": "95017524",
"primary": false
},
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "OH",
"license": "0028862",
"primary": false
},
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "TX",
"license": "1231287",
"primary": false
},
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "PA",
"license": "SP035463",
"primary": false
},
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "IA",
"license": "H189520",
"primary": false
},
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "MS",
"license": "908237",
"primary": false
},
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "GA",
"license": "APRN-NP335780",
"primary": true
},
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "MO",
"license": "2026009163",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Eagan, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2026; 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.
- 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.