Active NPI
Karen K Opp, NP
- Pediatric Nurse Practitioner
- Baxter, MN
National Provider Identifier
1013995257
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- CNP1167
- Practice address
- 13060 Isle Dr
Baxter, MN 56425-8331 - Phone
- (218) 828-2880
- NPI assigned
- Jan 6, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | R21613 | ND | |
| Pediatric Nurse Practitioner | 363LP0200X | CNP1167 | MN | Primary |
| Pediatric Nurse Practitioner | 363LP0200X | R113223-6 | MN |
Addresses
Primary practice location
13060 Isle Dr
Baxter, MN 56425-8331
Mailing address
Essentia Health Duluth Clinic MSS 6Av1-Pe
400 East Third Street
Duluth, MN 55805-1951
Phone (218) 786-3146
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 149815100 | Medicaid | MN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1167 | MN | MD | Registered Dietitian |
| CNP1167 | MN | MD | Pediatric Nurse Practitioner |
| R113223-6 | MN | MD | Pediatric Nurse Practitioner |
| R21613 | ND | MD | Pediatric Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136505600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1557273600000",
"number": "1013995257",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "ESSENTIA HEALTH DULUTH CLINIC MSS 6AV1-PE",
"address_2": "400 EAST THIRD STREET",
"city": "DULUTH",
"state": "MN",
"postal_code": "558051951",
"telephone_number": "218-786-3146"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13060 ISLE DR",
"city": "BAXTER",
"state": "MN",
"postal_code": "564258331",
"telephone_number": "218-828-2880"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OPP",
"first_name": "KAREN",
"middle_name": "K",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-06",
"last_updated": "2019-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "ND",
"license": "R21613",
"primary": false
},
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "MN",
"license": "CNP1167",
"primary": true
},
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "MN",
"license": "R113223-6",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "149815100",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Baxter, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.