Individual provider Active NPI

Lynda Jean Stuber, C.P.N.P.

  • Pediatric Nurse Practitioner
  • Minnetonka, MN
National Provider Identifier
1871560441
Registry record updated Nov 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
R177423-8 Issued in MN
Practice address
14001 Ridgedale Dr
Ste 100
Minnetonka, MN 55305-1781
Phone
(952) 473-0211
Fax
(952) 473-7908
NPI assigned
Mar 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 290-033 WI
Pediatric Nurse Practitioner 363LP0200X R177423-8 MN Primary

Addresses

Primary practice location

14001 Ridgedale Dr
Ste 100
Minnetonka, MN 55305-1781

Mailing address

140001 Ridgedale Dr
Ste 100
Minnetonka, MN 55305-1781
Phone (952) 473-0211

Other names 1

  • Lynda Jean Kempken Former name

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)
Not enrolled
Credentials
Certified Pediatric Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R177423-8MNMDPediatric Nurse Practitioner
290-033WIMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wayzata Children'S Clinic P.a. PastSince Sep 17, 2010 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1141257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384300800000",
    "number": "1871560441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140001 RIDGEDALE DR",
            "address_2": "STE 100",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553051781",
            "telephone_number": "952-473-0211",
            "fax_number": "952-473-7908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14001 RIDGEDALE DR",
            "address_2": "STE 100",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553051781",
            "telephone_number": "952-473-0211",
            "fax_number": "952-473-7908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUBER",
        "first_name": "LYNDA",
        "middle_name": "JEAN",
        "name_prefix": "Ms.",
        "credential": "C.P.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-02",
        "last_updated": "2013-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "WI",
            "license": "290-033",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MN",
            "license": "R177423-8",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LYNDA",
            "last_name": "KEMPKEN",
            "middle_name": "JEAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Minnetonka, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2013; 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.