Basic Information
| Provider Information | |||||||||
| NPI: | 1811916125 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LOHR | ||||||||
| FirstName: | JAMIE | ||||||||
| MiddleName: | LYNNE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 420 DELAWARE STREET SE, MMC 94 | ||||||||
| Address2: | UNIVERSITY OF MINNESOTA PHYSICIANS | ||||||||
| City: | MINNEAPOLIS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 55455 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6126262755 | ||||||||
| FaxNumber: | 6126262467 | ||||||||
| Practice Location | |||||||||
| Address1: | 516 DELAWARE STREET SE, PWB FOURTH FLOOR, ROOM 4-100 | ||||||||
| Address2: | UNIVERSITY OF MINNESOTA PHYSICIANS | ||||||||
| City: | MINNEAPOLIS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 55455 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6126266777 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/18/2006 | ||||||||
| LastUpdateDate: | 07/09/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 36353 | MN | X | Allopathic & Osteopathic Physicians | Pediatrics | 2080P0202X | 36353 | MN | X | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Cardiology |
ID Information
| ID | Type | State | Issuer | Description | 120732 | 01 | MN | UCARE | OTHER | 14R16LO | 01 | MN | BCBS | OTHER | 25-00039 | 01 | MN | MEDICA CHOICE | OTHER | 0052241 | 05 | MT | MEDICAID | HP23701 | 01 | MN | HEALTHPARTNERS | OTHER | 0984005 | 05 | IA | MEDICAID | 1015983 | 01 | MN | PREFERRED ONE | OTHER | 25-70103 | 01 | MN | MEDICA PRIMARY | OTHER | 768233 | 01 | MN | ARAZ | OTHER |