Individual provider Active NPI

Laurel D Edinburgh, CPNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Minneapolis, MN
National Provider Identifier
1871552323
Registry record updated Jun 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R144789-9 Issued in MN
Practice address
1716 Irving Ave S
Minneapolis, MN 55403-2817
Phone
(612) 719-5392
NPI assigned
Mar 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1215 MN
Pediatric Nurse Practitioner 363LP0200X R1447989 MN
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R144789-9 MN Primary

Addresses

Primary practice location

1716 Irving Ave S
Minneapolis, MN 55403-2817

Mailing address

2550 University Ave W Ste 229N
Saint Paul, MN 55114-1902
Phone (651) 645-3115

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20241015002420 PA Practitioner - Nurse Practitioner 2264964220 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Co Mhar IncGroup PAC ID 1951398452, 22 clinicians

Practice addresses (Care Compare)

2055 E Allegheny Ave
Philadelphia, PA 19134-3832
Phone (215) 427-5800

2600 N American St
Philadelphia, PA 19133-3413
Phone (215) 739-2669

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Pediatric Nurse Practitioner, Master of Arts, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1215MNMDGenetic Counselor (M.S.)
R1447989MNMDPediatric Nurse Practitioner
R144789-9MNMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Comhar, Inc Current Accepting new patients
Comhar Inc CurrentSince Sep 9, 2024 Accepting new patients
Psych Recovery Inc CurrentSince Aug 1, 2021 Accepting new patients
Childrens Health Care Associates of New Jersey PC Past Accepting new patients
Psychiatric Recovery PA PastSince Aug 1, 2021 Accepting new patients

Locations

2550 University Ave W
Ste 229N
Saint Paul, MN 55114
Phone (651) 645-3115

2055 E Allegheny Ave
Philadelphia, PA 19134
Phone (215) 427-5800

100 W Lehigh Ave
Philadelphia, PA 19133
Phone (215) 203-3000

Organizations & group practices 5

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": "1142985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718928000000",
    "number": "1871552323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 UNIVERSITY AVE W STE 229N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551141902",
            "telephone_number": "651-645-3115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1716 IRVING AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554032817",
            "telephone_number": "612-719-5392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDINBURGH",
        "first_name": "LAUREL",
        "middle_name": "D",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-22",
        "last_updated": "2024-06-21",
        "certification_date": "2024-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "1215",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MN",
            "license": "R1447989",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "R144789-9",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.