Individual provider Active NPI

Jacqueline Monique Lohonen, NP C

  • Family Nurse Practitioner
  • Blaine, MN
National Provider Identifier
1710233036
Registry record updated Nov 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F0712367 Issued in MN
Practice address
1500 109TH Ave NE
Blaine, MN 55449-4670
Phone
(651) 631-0330
NPI assigned
Jul 24, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F0712367 MN Primary

Addresses

Primary practice location

1500 109TH Ave NE
Blaine, MN 55449-4670

Mailing address

3226 149TH Ave NE
Ham Lake, MN 55304-6433
Phone (651) 270-7975

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121107000209 MN Practitioner - Nurse Practitioner 7911158688 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Minuteclinic Diagnostic of Minnesota PAGroup PAC ID 7810289949, 83 clinicians
Minuteclinic Primary Care Minnesota PLLCGroup PAC ID 2163945460, 30 clinicians

Practice addresses (Care Compare)

1515 County Rd B W
Roseville, MN 55113-6005
Phone (866) 389-2727

2357 108TH LN NE
Blaine, MN 55449-5222
Phone (866) 389-2727

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F0712367MNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic Diagnostic of Minnesota, P.a. Family CurrentSince Jun 1, 2016 Accepting new patients
Minuteclinic Primary Care Minnesota PLLC Family CurrentSince Apr 1, 2025 Accepting new patients

Locations

2357 108th Ln NE
Blaine, MN 55449
Phone (763) 780-0776

900 Nicollet Mall
Minneapolis, MN 55403
Phone (612) 338-0085

1500 109th Ave NE
Minneapolis, MN 55449
Phone (763) 354-1000

1010 W Lake St
Minneapolis, MN 55408
Phone (612) 822-1297

1040 Grand Ave
Saint Paul, MN 55105
Phone (651) 224-2155

1515 County Road B W
Saint Paul, MN 55113
Phone (651) 631-0330

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989

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": "1343088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667347200000",
    "number": "1710233036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3226 149TH AVE NE",
            "city": "HAM LAKE",
            "state": "MN",
            "postal_code": "553046433",
            "telephone_number": "651-270-7975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 109TH AVE NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554494670",
            "telephone_number": "651-631-0330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOHONEN",
        "first_name": "JACQUELINE",
        "middle_name": "MONIQUE",
        "credential": "NP C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-24",
        "last_updated": "2022-11-02",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "F0712367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blaine, MN

Sources for this page

Verify at the official NPI Registry.