OrganizationActive
South Lake Clinic, PA
NPI 1780015008 · Pediatrics Physician · Chaska, MN
South Lake Clinic, PA is a Pediatrics Physician organization in Chaska, MN (NPI 1780015008).
Provider details
- NPI number
- 1780015008
- Entity type
- Organization
- Primary specialty
- Pediatrics PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Heidi Northrup, Administrator(952) 401-8300
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(76/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
12 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
111 Hundertmark Rd Ste 210
Chaska, MN 55318-1196
Phone: (952) 401-8300
Fax: (952) 401-8243
Street-level locationGet directions
Mailing address
17705 Hutchins Dr Ste 250
Minnetonka, MN 55345-4103
Other names (DBA / former)
- Doing business as
- South Lake Pediatrics
- Doing business as
- South Lake Pediatrics
Registry dates
- Enumerated
- 2013-12-12
- Last updated
- 2023-08-29
- Certified
- 2023-08-29
Frequently asked questions
- What is South Lake Clinic, PA's NPI number?
- South Lake Clinic, PA's National Provider Identifier (NPI) is 1780015008, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is South Lake Clinic, PA?
- South Lake Clinic, PA is classified in the NPPES registry as Pediatrics Physician (Allopathic & Osteopathic Physicians).
- Where is South Lake Clinic, PA located?
- South Lake Clinic, PA's practice location on file with NPPES is 111 Hundertmark Rd Ste 210, Chaska, MN 55318-1196.
- What is South Lake Clinic, PA's phone number?
- The practice phone number listed in the NPPES registry for South Lake Clinic, PA is (952) 401-8300.
- Who is the authorized official for South Lake Clinic, PA?
- The authorized official listed on South Lake Clinic, PA's NPPES record is Heidi Northrup, Administrator. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is South Lake Clinic, PA's NPI active?
- Yes — South Lake Clinic, PA's NPI (1780015008) is active in the NPPES registry as of the last update on 2023-08-29.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.