Individual provider Active NPI

Lauren Kennerly

  • Adult Health Nurse Practitioner
  • Eagan, MN
National Provider Identifier
1699376996
Registry record updated Jun 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
APRN-NP335780 Issued in GA
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

Updated by the provider on Jun 22, 2026

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

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

LicenseStateTypeSpecialty
041425398ILMDRegistered Nurse
3-002805ALMDAdult Health Nurse Practitioner
C-APN.0106154-C-NPCOMDAdult Health Nurse Practitioner
APRN11045621FLMDAdult Health Nurse Practitioner
APRN-NP335780GAMDAdult Health Nurse Practitioner
H189520IAMDAdult Health Nurse Practitioner
2026009163MOMDAdult Health Nurse Practitioner
908237MSMDAdult Health Nurse Practitioner
5024485NCMDAdult Health Nurse Practitioner
0028862OHMDAdult Health Nurse Practitioner
SP035463PAMDAdult Health Nurse Practitioner
1231287TXMDAdult Health Nurse Practitioner
95017524CAMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Devoted Medical Group Professional Corporation CurrentSince Jul 13, 2026 Accepting new patients
Pacific Pace, LLC PastSince Jul 1, 2021 Accepting new patients

Interoperability endpoints

  • FHIR API: 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.

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

Verify at the official NPI Registry.