Individual provider Active NPI

Lisa Marie Gregory, CNM, APRN

  • Advanced Practice Midwife
  • Minneapolis, MN
National Provider Identifier
1821846882
Registry record updated May 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
579 Issued in MN
Practice address
324 E 35TH St
Minneapolis, MN 55408-4580
Phone
(612) 827-7181
NPI assigned
May 7, 2024
Last updated
May 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 579 MN Primary

Addresses

Primary practice location

324 E 35TH St
Minneapolis, MN 55408-4580

Mailing address

7830 36TH St N Apt 1311
Oakdale, MN 55128-5780
Phone (651) 285-6856

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241002001861 MN Practitioner - Certified Nurse Midwife (CNM) 2769913623

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southside Community Health Services, Inc. CurrentSince Jul 20, 2024 Accepting new patients
Southside Community Health Services, Inc. CurrentSince Jul 20, 2024 Accepting new patients

Locations

4243 4th Ave S
Minneapolis, MN 55409
Phone (612) 821-2003

324 E 35th St
Minneapolis, MN 55408
Phone (612) 827-7181

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1715040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1821846882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7830 36TH ST N APT 1311",
            "city": "OAKDALE",
            "state": "MN",
            "postal_code": "551285780",
            "telephone_number": "651-285-6856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 E 35TH ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554084580",
            "telephone_number": "612-827-7181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREGORY",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "credential": "CNM, APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-07",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "MN",
            "license": "579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.