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NORTHERN LIGHTS PEDIATRIC & ADOLESCENT MEDICINE
NPI 1912069519
Pediatrics - Adolescent Medicine in Vadnais Heights, MN

Active since December 14, 2006CLIA 24D0399415 · Accreditation
3555 WILLOW LAKE BLVD., SUITE 140, VADNAIS HEIGHTS, MN 55110(651) 251-5280(651) 251-5282 Get Directions Write a Review

NPPES record last updated: May 20, 2009. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Northern Lights Pediatric & Adolescent Medicine NPPES

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

NORTHERN LIGHTS PEDIATRIC & ADOLESCENT MEDICINE (NPI 1912069519) is a healthcare organization registered as an adolescent medicine in Vadnais Heights, Minnesota and active in the NPI registry since December 2006. The organization holds an CLIA Accreditation certificate valid through December 22, 2027 and lists Wendy Marian Nelms Mccabe, Partner, as its authorized official.

NPPES Registry Identity

NPI1912069519
Entity TypeOrganization
Primary Taxonomy2080A0000X
Legal Business NameNORTHERN LIGHTS PEDIATRIC & ADOLESCENT MEDICINE
Location Address3555 WILLOW LAKE BLVD., SUITE 140Vadnais Heights, MN 55110-4462
Mailing Address3555 Willow Lake Blvd., Suite 140Vadnais Heights, MN 55110-4462 · (651) 251-5280 · Fax (651) 251-5282
Phone(651) 251-5280
Fax(651) 251-5282
Organization SubpartNo
Authorized OfficialWendy Marian Nelms MccabePartner · (651) 251-5280
Enumeration DateDecember 14, 2006
Last NPPES UpdateMay 20, 2009
✔ NPI 1912069519 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Adolescent MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2080A0000X
Definition
A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
3555 WILLOW LAKE BLVD., Vadnais Heights, MN 55110
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Other Identifiers 3

Other29960NOMN · Bcbs Mn
Medicaid744432000MN
Other165339MN · Ucare

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HealthPartners, Medica.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Accreditation 24D0399415

Northern Lights Pediatrics · Vadnais Heights, MN
Active · expires Dec 22, 2027
CLIA Number24D0399415
Laboratory TypePhysician Office
Certificate Effective DateDecember 23, 2025
Certificate Expiration DateDecember 22, 2027
Laboratory DirectorDr. Wendy M. Mccabe
Laboratory Phone(651) 770-2124
Laboratory LocationNorthern Lights Pediatrics3555 Willow Lake Blvd, Suite 140, Vadnais Heights, MN 55110
CLIA data matches this NPI record on: Address
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

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 Northern Lights Pediatric & Adolescent Medicine's NPI number?

The NPI number for Northern Lights Pediatric & Adolescent Medicine is 1912069519. It was assigned to this organization in the NPPES registry on December 14, 2006.

Where is Northern Lights Pediatric & Adolescent Medicine located?

Northern Lights Pediatric & Adolescent Medicine is located at 3555 Willow Lake Blvd. Suite 140, Vadnais Heights, MN 55110. The listed phone number is (651) 251-5280.

What is Northern Lights Pediatric & Adolescent Medicine's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Adolescent Medicine, with taxonomy code 2080A0000X.

Does Northern Lights Pediatric & Adolescent Medicine hold a CLIA laboratory certificate?

Yes. A Certificate of Accreditation (number 24D0399415) is associated with this NPI, valid through December 22, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Northern Lights Pediatric & Adolescent Medicine accept?

Health plans from HealthPartners and Medica list Northern Lights Pediatric & Adolescent Medicine as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Northern Lights Pediatric & Adolescent Medicine was last updated on May 20, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.