Lisa Pivotto Kroening, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

R111593 Issued in MN

Practice address

18315 Cascade Dr
Ste 170
Eden Prairie, MN 55347-1180

Phone

(952) 831-1944

Fax

(952) 278-6947

NPI assigned

Oct 26, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/1846cf9e-8006-4277-b72f-3cbbe8a8f5ca/

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.

• Southdale Pediatric Associates, LTD

  • Multi-Specialty Clinic/Center
  • Edina, MN
  • NPI 1245305895
  NPD (past)

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821173956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3955 PARKLAWN AVE",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554355655",
            "telephone_number": "952-831-1944",
            "fax_number": "952-278-6947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18315 CASCADE DR",
            "address_2": "STE 170",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553471180",
            "telephone_number": "952-831-1944",
            "fax_number": "952-278-6947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIVOTTO KROENING",
        "first_name": "LISA",
        "credential": "CPNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MN",
            "license": "R111593",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "FP9021013319",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "1200184",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "9G994KR",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pioneeer Estates
• Pioneer Care LLC (Pioneer Estates)
• Jeffrey Pionkowski, BCBA , MA
• Nevaeh Fae Pitts-Nelson
• Sarah Renee Pivec, OTR/L
• Planned Parenthood Minnesota, North Dakota, South Dakota
• Platinum Ventures (Housecalls Network)
• Sheryl Jayne Pleiss, PH.D., LP
• Pmi Acquisition, LLC
• Sukay Polley

• Pediatric Nurse Practitioner in Eden Prairie, MN
• Providers in Eden Prairie, MN by specialty
• Pediatric Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.