NPIMap

Individual provider Active NPI

Lynne M Didrikson I, MD

  • Family Medicine Physician
  • Cook, MN
National Provider Identifier
1841381852
Registry record updated Jul 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
27836 Issued in MN
Practice address
20 5TH St SE
Cook, MN 55723-9702
Phone
(218) 666-5941
NPI assigned
Sep 27, 2006
Last updated
Jul 28, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 27836 MN Primary

Addresses

Primary practice location

20 5TH St SE
Cook, MN 55723-9702

Mailing address

20 5TH St SE
Cook, MN 55723
Phone (218) 666-5941

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Medexpress Urgent Care Minnesota P.C. PastSince Jul 20, 2016 Accepting new patients

Organizations & group practices 1

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": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248739200000",
    "number": "1841381852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 5TH ST SE",
            "city": "COOK",
            "state": "MN",
            "postal_code": "55723",
            "telephone_number": "218-666-5941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 5TH ST SE",
            "city": "COOK",
            "state": "MN",
            "postal_code": "557239702",
            "telephone_number": "218-666-5941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIDRIKSON",
        "first_name": "LYNNE",
        "middle_name": "M",
        "name_suffix": "I",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2009-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "27836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cook, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2009; 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.