MILES MED MANAGEMENT
NPI 1225703705
Nurse Practitioner - Psychiatric/Mental Health in Saint Louis Park, MN

Q: What is Miles Med Management Service Corporation's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Active since August 16, 2021

5775 WAYZATA BLVD STE 767, SAINT LOUIS PARK, MN 55416(612) 708-7562(507) 738-1963 Get Directions Write a Review

NPPES record last updated: September 15, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Sep 15, 2021, Aug 18, 2021 (2 updates tracked since 2021).

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About Miles Med Management NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MILES MED MANAGEMENT (NPI 1225703705) is a healthcare organization registered as a psychiatric/mental health in Saint Louis Park, Minnesota and active in the NPI registry since August 2021. The organization lists Lisa Ann Miles, Nurse Practitioner, as its authorized official.

NPPES Registry Identity

NPI1225703705

Entity TypeOrganization

Primary Taxonomy363LP0808X

Legal Business NameMILES MED MANAGEMENT SERVICE CORPORATION

Location Address5775 WAYZATA BLVD STE 767Saint Louis Park, MN 55416-1222

Mailing Address4301 Elliot AveMinneapolis, MN 55407-3156 · (612) 708-7562 · Fax (507) 738-1963

Phone(612) 708-7562

Fax(507) 738-1963

Organization SubpartNo

Authorized OfficialLisa Ann MilesNurse Practitioner · (612) 708-7562

Enumeration DateAugust 16, 2021

Last NPPES UpdateSeptember 15, 20212 updates tracked since enumeration

NPPES CertifiedSeptember 14, 2021

✔ NPI 1225703705 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

5775 WAYZATA BLVD STE 767, Saint Louis Park, MN 55416

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Other Names 1

Doing Business AsMiles Med Management

Other Identifiers 2

Medicaid1093741886MN

Medicaid1225703705MN

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ALLEN STOCK LICENSED PSYCHOLOGIS

Psychologist (Clinical)

5775 WAYZATA BLVD STE 767
ST LOUIS PARK, MN 55416

Hennepin County (612) 799-6263

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Miles Med Management Service Corporation's NPI number?

The NPI number for Miles Med Management Service Corporation is 1225703705. It was assigned to this organization in the NPPES registry on August 16, 2021. The provider is doing business as Miles Med Management.

Where is Miles Med Management Service Corporation located?

Miles Med Management Service Corporation is located at 5775 Wayzata Blvd Ste 767, Saint Louis Park, MN 55416. The listed phone number is (612) 708-7562.

What is Miles Med Management Service Corporation's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

When was this NPI record last updated?

The NPPES record for Miles Med Management Service Corporation was last updated on September 15, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.