Active NPI
Kim Wangen
- Nurse Practitioner
- Austin, MN
National Provider Identifier
1023448313
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 225
- Practice address
- 1000 1St Dr NW
Austin, MN 55912-2941 - Phone
- (507) 433-7351
- NPI assigned
- Nov 22, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | R 127304-3 | MN | |
| Nurse Practitioner | 363L00000X | 225 | MN | Primary |
Addresses
Primary practice location
1000 1St Dr NW
Austin, MN 55912-2941
Mailing address
1000 1St Dr NW
Austin, MN 55912-2941
Phone (507) 433-7351
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R 127304-3 | MN | MD | Nurse Practitioner |
Interoperability endpoints
- kwangen89712@ehrdirect.mayoclinicmsg.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1385078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1706572800000",
"number": "1023448313",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 1ST DR NW",
"city": "AUSTIN",
"state": "MN",
"postal_code": "559122941",
"telephone_number": "507-433-7351"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 1ST DR NW",
"city": "AUSTIN",
"state": "MN",
"postal_code": "559122941",
"telephone_number": "507-433-7351"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WANGEN",
"first_name": "KIM",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-11-22",
"last_updated": "2024-01-30",
"certification_date": "2024-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MN",
"license": "R 127304-3",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MN",
"license": "225",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, MN
- Wal-Mart Stores, Inc. (Walmart Vision CEnter 30-4257)
- Walgreen Co (Walgreens #09094)
- Walleye Dental LLC
- Katherine Wallin, LICSW
- Walmart Inc. (Walmart Pharmacy 10-4257)
- Wapiti Meadows Community Technologies and Services
- Wapiti Meadows Community Technologies and Services
- Rachel Lee Weatherly, RDH, BSDH, QOM
- Kari Lynne Weber, RRT, AE-C
- Wellness 1St of Austin Inc
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.