Individual provider Active NPI

Laura Ellen Hart, MSN FNP CPNP

  • Family Nurse Practitioner
  • Minnetonka, MN
National Provider Identifier
1720072234
Registry record updated Jan 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R098456 Issued in MN
Practice address
12450 Wayzata Blvd
Suite 215 Ridge Plaza
Minnetonka, MN 55305-1978
Phone
(952) 546-6866
Fax
(952) 512-0038
NPI assigned
Sep 12, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2009

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 R098456 MN Primary

Addresses

Primary practice location

12450 Wayzata Blvd
Suite 215 Ridge Plaza
Minnetonka, MN 55305-1978

Mailing address

4436 Vincent Ave S
Minneapolis, MN 55410-1526
Phone (612) 920-0207

Other names 1

  • Laura Ellen Coffman Former name

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
I20050603000655 MN Practitioner - Nurse Practitioner 7214970946 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview ClinicsGroup PAC ID 7113830142, 799 clinicians

Practice addresses (Care Compare)

1440 Duckwood Dr
Eagan, MN 55122-1451
Phone (651) 406-8860

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R098456MNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Group Health, Inc. CurrentSince Oct 14, 2013 Accepting new patients
Group Health, Inc. Current Accepting new patients
Fairview Clinics Current Accepting new patients
Group Health, Inc. CurrentSince Oct 14, 2013 Accepting new patients
Fairview Clinics CurrentSince Mar 14, 2014 Accepting new patients
Fairview Clinics CurrentSince Mar 14, 2014 Accepting new patients
Fairview Clinics Past Accepting new patients

Locations

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

800 E 28th St
Minneapolis, MN 55407
Phone (612) 863-3547

3033 Excelsior Blvd
Ste 275
Minneapolis, MN 55416
Phone (612) 827-4751

401 Phalen Blvd
Saint Paul, MN 55130
Phone (651) 254-7870

Interoperability endpoints

  • Direct secure messaging: lhart316170@fairview.direct-ci.com

Organizations & group practices 7

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": "1126483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232323200000",
    "number": "1720072234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4436 VINCENT AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554101526",
            "telephone_number": "612-920-0207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12450 WAYZATA BLVD",
            "address_2": "SUITE 215 RIDGE PLAZA",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553051978",
            "telephone_number": "952-546-6866",
            "fax_number": "952-512-0038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HART",
        "first_name": "LAURA",
        "middle_name": "ELLEN",
        "credential": "MSN  FNP  CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-12",
        "last_updated": "2009-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "R098456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "COFFMAN",
            "middle_name": "ELLEN",
            "credential": "MSN  FNP  CPNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Minnetonka, MN

Sources for this page

Verify at the official NPI Registry.