NPIMap

Organization Active NPI

Lakeview Memorial Hospital Association Inc.

  • Neonatal Nurse Practitioner
  • Stillwater, MN
National Provider Identifier
1821114729
Registry record updated Aug 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
License
365380 Issued in MN
Legal business name
LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION INC.
Practice address
927 Churchill St W
Stillwater, MN 55082-6605
Phone
(651) 430-4529
Fax
(651) 430-4528
NPI assigned
Mar 22, 2007
Organization subpart
Yes
Parent organization
LAKEVIEW MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 3, 2026

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

Authorized official

Name
Brandi Lunneborg
Title
President
Phone
(651) 430-5207

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X
Hematology & Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RH0003X
Neonatal Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LN0000X 365380 MN Primary

Addresses

Primary practice location

927 Churchill St W
Stillwater, MN 55082-6605

Mailing address

PO Box 310
Stillwater, MN 55082-1029
Phone (651) 430-4529

Other identifiers 8

IdentifierTypeStateIssuer
300064OtherMNUCARE
56697TEOtherMNBLUE CROSS MN
110674OtherMNHEALTHPARTNERS
32889100MedicaidWI
834547300MedicaidMN
65247OtherMNPREFERRED ONE
C63317OtherMNMEDICARE RAILROAD
3946489OtherMNMEDICA CHOICE

Other names 1

  • Lakeview Hospital Physicians Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031104000543 MN Part B Supplier - Clinic/Group Practice 1951210855 Receives reassigned benefits from 145 practitioners
Practice locations: Stillwater, MN

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Part of
Lakeview Community Pharmacy

Locations

927 Churchill St W
Ste 110
Stillwater, MN 55082

919 Anderson St W
Stillwater, MN 55082

Practitioners & affiliated clinicians

Practitioners 177

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 177

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785715200000",
    "number": "1821114729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 310",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550821029",
            "telephone_number": "651-430-4529",
            "fax_number": "651-430-4528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "927 CHURCHILL ST W",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550826605",
            "telephone_number": "651-430-4529",
            "fax_number": "651-430-4528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LAKEVIEW MEMORIAL HOSPITAL",
        "enumeration_date": "2007-03-22",
        "last_updated": "2026-08-03",
        "certification_date": "2026-08-03",
        "status": "A",
        "authorized_official_last_name": "LUNNEBORG",
        "authorized_official_first_name": "BRANDI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "651-430-5207"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "MN",
            "license": "365380",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "300064",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS MN",
            "identifier": "56697TE",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "110674",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32889100",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "834547300",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "65247",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "C63317",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA CHOICE",
            "identifier": "3946489",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakeview Hospital Physicians",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Lakeview Hospital Physicians",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Stillwater, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.