Individual provider Active NPI

Lauren Loberg, PT

  • Physical Therapist
  • White Bear Lake, MN
National Provider Identifier
1891980819
Registry record updated Sep 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
7993 Issued in MN
Practice address
4465 White Bear Pkwy
White Bear Lake, MN 55110-7623
Phone
(651) 653-1350
NPI assigned
Sep 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 7993 MN Primary

Addresses

Primary practice location

4465 White Bear Pkwy
White Bear Lake, MN 55110-7623

Mailing address

7581 9TH St N
Suite 100
Oakdale, MN 55128-6626

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071003000601 MN Practitioner - Physical Therapist in Private Practice 9032204268 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Minnesota Medical School, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tria Orthopaedic Center LLCGroup PAC ID 3173570561, 504 clinicians

Practice addresses (Care Compare)

3800 American Blvd W
Suite 200
Bloomington, MN 55431-4420
Phone (952) 831-8742

8100 Northland Dr
Bloomington, MN 55431-4800
Phone (952) 831-8742

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7993MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Tria Orthopaedic Center LLC CurrentSince Jan 9, 2012 Accepting new patients
Tria Orthopaedic Center LLC Physical Therapist CurrentSince Jan 9, 2012 Accepting new patients

Locations

8100 Northland Dr
Minneapolis, MN 55431
Phone (952) 831-1626

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1189555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189555200000",
    "number": "1891980819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7581 9TH ST N",
            "address_2": "SUITE 100",
            "city": "OAKDALE",
            "state": "MN",
            "postal_code": "551286626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4465 WHITE BEAR PKWY",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551107623",
            "telephone_number": "651-653-1350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOBERG",
        "first_name": "LAUREN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-12",
        "last_updated": "2007-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "7993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in White Bear Lake, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.