Provider Demographics
NPI:1811916125
Name:LOHR, JAMIE LYNNE (MD)
Entity type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:LYNNE
Last Name:LOHR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 DELAWARE STREET SE, MMC 94
Mailing Address - Street 2:UNIVERSITY OF MINNESOTA PHYSICIANS
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55455
Mailing Address - Country:US
Mailing Address - Phone:612-626-2755
Mailing Address - Fax:612-626-2467
Practice Address - Street 1:2450 RIVERSIDE AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55454-1450
Practice Address - Country:US
Practice Address - Phone:612-672-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN36353208000000X, 2080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN25-00039OtherMEDICA CHOICE
MN25-70103OtherMEDICA PRIMARY
MN120732OtherUCARE
MN14R16LOOtherBCBS
MNHP23701OtherHEALTHPARTNERS
IA0984005Medicaid
MN884964100Medicaid
MT0052241Medicaid
MN1015983OtherPREFERRED ONE
MN768233OtherARAZ