Individual provider Active NPI

Laurel Oluchi Anderson, APRN, DNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Lake Elmo, MN
National Provider Identifier
1942086541
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
10719 Issued in MN
Practice address
8550 Hudson Blvd N
Lake Elmo, MN 55042-5500
Phone
(612) 371-5400
NPI assigned
Sep 7, 2023
Last updated
Apr 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 10719 MN Primary

Addresses

Primary practice location

8550 Hudson Blvd N
Lake Elmo, MN 55042-5500

Mailing address

1755 Otter Way
New Richmond, WI 54017-4414
Phone (218) 260-5207

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20240501003296 MN Practitioner - Nurse Practitioner 6709226137 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Group Health IncGroup PAC ID 1759293954, 1,627 clinicians

Practice addresses (Care Compare)

8550 Hudson Blvd N
Lake Elmo, MN 55042-5500
Phone (651) 254-8580

8600 Nicollet Ave
Bloomington, MN 55420-2824
Phone (952) 884-1148

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10719MNMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Group Health, Inc. Single Specialty Current Accepting new patients
Group Health, Inc. CurrentSince Mar 19, 2024 Accepting new patients
Group Health Plan, Inc. CurrentSince Mar 19, 2024 Accepting new patients

Locations

8550 Hudson Blvd N
Lake Elmo, MN 55042
Phone (651) 254-8580

8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375

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

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1694044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714435200000",
    "number": "1942086541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1755 OTTER WAY",
            "city": "NEW RICHMOND",
            "state": "WI",
            "postal_code": "540174414",
            "telephone_number": "218-260-5207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8550 HUDSON BLVD N",
            "city": "LAKE ELMO",
            "state": "MN",
            "postal_code": "550425500",
            "telephone_number": "612-371-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "LAUREL",
        "middle_name": "OLUCHI",
        "name_prefix": "Dr.",
        "credential": "APRN, DNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-07",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "10719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Elmo, MN

Sources for this page

Verify at the official NPI Registry.