Individual provider Active NPI

Kelly Jean Killian, NP

  • Women's Health Nurse Practitioner
  • Minneapolis, MN
National Provider Identifier
1013478775
Registry record updated Apr 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
7373 Issued in MN
Practice address
121 Washington Ave N FL 2
Minneapolis, MN 55401-2503
Phone
(888) 731-8994
NPI assigned
Mar 26, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 7373 MN Primary
Gynecologic Oncology Physician 207VX0201X 0024177448 VA
Women's Health Nurse Practitioner 363LW0102X R262947 MD
Women's Health Nurse Practitioner 363LW0102X 500013722 DC

Addresses

Primary practice location

121 Washington Ave N FL 2
Minneapolis, MN 55401-2503

Mailing address

121 Washington Ave N FL 2
Minneapolis, MN 55401-2503

Other practice location 1

101 S Reid St Ste 307
Sioux Falls, SD 57103-7045
Phone (888) 731-8994

Other practice location 2

1433 N Water St
Milwaukee, WI 53202-2557
Phone (888) 731-8994

Other practice location 3

1531 32nd Ave S Ste 102
Fargo, ND 58103-5911
Phone (888) 731-8994

Other practice location 4

421 Fayetteville St Ste 1100
Raleigh, NC 27601-3000
Phone (888) 731-8994

Other practice location 5

10440 Little Patuxent Pkwy Ste 300
Columbia, MD 21044-3648
Phone (888) 731-8994

Other practice location 6

1101 Pennsylvania Ave NW Ste 300
Washington, DC 20004-2582
Phone (800) 731-8994

Other practice location 7

1101 Wilson Blvd Fl 6
Arlington, VA 22209-2281
Phone (888) 731-8994

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200421000860 MN Practitioner - Nurse Practitioner 9931539632 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
88.63 of 100Reported as group
Quality
75.41
Promoting interoperability
100
Improvement activities
40
Cost
75.75

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0024177448VAMDGynecologic Oncology Physician
500013722DCMDWomen's Health Nurse Practitioner
R262947MDMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Health Services Current Accepting new patients
Fairview Express Care CurrentSince Oct 1, 2020 Accepting new patients
Fairview Clinics CurrentSince Aug 12, 2021 Accepting new patients
Fairview Express Care Current Accepting new patients
Fairview Clinics Current Accepting new patients
Fairview Express Care CurrentSince Oct 1, 2020 Accepting new patients
Fairview Clinics CurrentSince Aug 12, 2021 Accepting new patients
Fairview Health Services CurrentSince May 1, 2020 Accepting new patients

Locations

14101 Fairview Dr
Ste 300
Burnsville, MN 55337
Phone (612) 273-5400

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

14500 99th Ave N
Ste 100
Maple Grove, MN 55369
Phone (763) 898-1000

400 Stinson Blvd
Fl 2
Minneapolis, MN 55413
Phone (612) 672-2203

516 Delaware St SE
Minneapolis, MN 55455
Phone (612) 625-3600

909 Fulton St SE
Fl 2
Minneapolis, MN 55455
Phone (612) 676-4200

2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1553558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712793600000",
    "number": "1013478775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 WASHINGTON AVE N FL 2",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554012503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 WASHINGTON AVE N FL 2",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554012503",
            "telephone_number": "888-731-8994"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 S Reid St Ste 307",
            "address_purpose": "LOCATION",
            "city": "Sioux Falls",
            "state": "SD",
            "postal_code": "571037045",
            "country_code": "US",
            "telephone_number": "888-731-8994",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1433 N Water St",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532022557",
            "country_code": "US",
            "telephone_number": "888-731-8994",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1531 32nd Ave S Ste 102",
            "address_purpose": "LOCATION",
            "city": "Fargo",
            "state": "ND",
            "postal_code": "581035911",
            "country_code": "US",
            "telephone_number": "888-731-8994",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "421 Fayetteville St Ste 1100",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276013000",
            "country_code": "US",
            "telephone_number": "888-731-8994",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10440 Little Patuxent Pkwy Ste 300",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MD",
            "postal_code": "210443648",
            "country_code": "US",
            "telephone_number": "888-731-8994",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1101 Pennsylvania Ave NW Ste 300",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200042582",
            "country_code": "US",
            "telephone_number": "800-731-8994",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1101 Wilson Blvd Fl 6",
            "address_purpose": "LOCATION",
            "city": "Arlington",
            "state": "VA",
            "postal_code": "222092281",
            "country_code": "US",
            "telephone_number": "888-731-8994",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KILLIAN",
        "first_name": "KELLY",
        "middle_name": "JEAN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-26",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MN",
            "license": "7373",
            "primary": true
        },
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "VA",
            "license": "0024177448",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MD",
            "license": "R262947",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "DC",
            "license": "500013722",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.