Individual provider Active NPI

Lori Ann Pykkonen

  • Family Nurse Practitioner
  • Duluth, MN
National Provider Identifier
1881759629
Registry record updated Dec 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R128752-1 Issued in MN
Practice address
400 E 3Rd St
Duluth, MN 55805-1951
Phone
(218) 786-3443
NPI assigned
Dec 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Nurse Specialist 364S00000X R128752-1 MN
Family Nurse Practitioner 363LF0000X R128752-1 MN Primary

Addresses

Primary practice location

400 E 3Rd St
Duluth, MN 55805-1951

Mailing address

400 E 3Rd St
Duluth, MN 55805-1951
Phone (218) 343-6407

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100210000750 MN Practitioner - Nurse Practitioner 3779673280 Reassigns benefits to 3 organizations
I20200228001173 WI Practitioner - Nurse Practitioner 3779673280

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R128752-1MNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cook Area Health Services, Inc Current Accepting new patients
Cook Area Health Services, Inc Current Accepting new patients
Group Health, Inc. CurrentSince Feb 7, 2012 Accepting new patients
Cook Area Health Services, Inc CurrentSince Aug 1, 2018 Accepting new patients
Group Health, Inc. Family Medicine CurrentSince Feb 7, 2012 Accepting new patients
Cook Area Health Services, Inc CurrentSince Aug 1, 2018 Accepting new patients
Group Health, Inc. Current Accepting new patients
Cook Area Health Services, Inc Family Medicine Current Accepting new patients

Locations

135 Pine Tree Dr
Bigfork, MN 56628
Phone (218) 743-3232

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

239 McKinley Ave
Eveleth, MN 55734
Phone (218) 361-3300

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

12052 Main St
Northome, MN 56661
Phone (218) 897-5222

Organizations & group practices 8

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": "1166745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261008000000",
    "number": "1881759629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-343-6407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-786-3443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PYKKONEN",
        "first_name": "LORI",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-22",
        "last_updated": "2009-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "MN",
            "license": "R128752-1",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "R128752-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.