Lisa Gail Brown, RD,LD,CDE

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

1036 Issued in MN

Practice address

6401 University Ave NE
Suite 200
Fridley, MN 55432-4341

Phone

(763) 502-4877

Fax

(763) 856-6906

NPI assigned

Aug 31, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Columbia Park Medical Group, PA

  • Family Medicine Physician
  • Fridley, MN
  • NPI 1932150117
  NPD (past)

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

{
    "created_epoch": "1251676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251676800000",
    "number": "1902039548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6401 UNIVERSITY AVE NE",
            "address_2": "SUITE 200",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554324341",
            "telephone_number": "763-502-4877",
            "fax_number": "763-856-6906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6401 UNIVERSITY AVE NE",
            "address_2": "SUITE 200",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554324341",
            "telephone_number": "763-502-4877",
            "fax_number": "763-856-6906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "LISA",
        "middle_name": "GAIL",
        "name_prefix": "Mrs.",
        "credential": "RD,LD,CDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-31",
        "last_updated": "2009-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MN",
            "license": "1036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Brausen, DPT
• Jeffrey L Brenna, PHARMD
• Ellen Brice
• Daniel Spencer Brooks, APRN
• Kaydee E Brown, LD
• Sanay Laneice Brown
• Jennifer Ann Brummer, PHARMD
• Calie Bryanne Budnick, LICSW
• Yen Bui
• Colleen Barbara Burke, LADC

• Registered Dietitian in Fridley, MN
• Providers in Fridley, MN by specialty
• Registered Dietitian in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 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.