Kyle Robert Elliott, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

CNP 4392 Issued in MN

Practice address

1101 Moulton and Parsons Dr
Saint James, MN 56081-5550

Phone

(507) 375-3261

NPI assigned

Mar 2, 2016

Last updated

Oct 26, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Mayo Clinic Health System-Fairmont

  • Multi-Specialty Clinic/Center
  • Fairmont, MN
  • NPI 1366410862
  Medicare reassignment NPD
• Mayo Clinic Health System-Lake City

  • Multi-Specialty Clinic/Center
  • Lake City, MN
  • NPI 1164463659
  Medicare reassignment NPD
• Mayo Clinic Health System-Lake City

  • Critical Access Hospital
  • Lake City, MN
  • NPI 1538113022
  Medicare reassignment NPD
• Mayo Clinic Health System-Southeast Minnesota Region

  dba Mayo Clinic Health System-Cannon Falls

  • Critical Access Hospital
  • Cannon Falls, MN
  • NPI 1063435410
  Medicare reassignment NPD
• Mayo Clinic Health System-Southeast Minnesota Region

  dba Mayo Clinic Health System-Albert Lea and Austin

  • Multi-Specialty Clinic/Center
  • Albert Lea, MN
  • NPI 1891701637
  Medicare reassignment NPD
• Mayo Clinic Health System-Southwest Minnesota Region

  dba Mayo Clinic Health System-New Prague

  • Critical Access Hospital
  • New Prague, MN
  • NPI 1124035282
  Medicare reassignment NPD
• Mayo Clinic Health System-Southwest Minnesota Region

  dba Mayo Clinic Health System - Mankato

  • Multi-Specialty Clinic/Center
  • Mankato, MN
  • NPI 1578545422
  Medicare reassignment NPD
• Mayo Clinic Health System-St James

  • Multi-Specialty Clinic/Center
  • Saint James, MN
  • NPI 1023177730
  Medicare reassignment NPD
• Mayo Clinic Health System-St James

  • Critical Access Hospital
  • Saint James, MN
  • NPI 1639198732
  Medicare reassignment NPD
• Mayo Clinic Health System-Southwest Minnesota Region

  dba Mayo Clinic Health System-Waseca

  • Critical Access Hospital
  • Waseca, MN
  • NPI 1740256668
  Medicare reassignment
• Mayo Clinic Health System-Southeast Minnesota Region

  dba Mayo Clinic Health System Pharmacy - Cannon Falls

  • Clinic Pharmacy
  • Cannon Falls, MN
  • NPI 1699597468
  NPD
• Mayo Clinic Health System-Southwest Minnesota Region

  dba Mayo Clinic Health System-Waseca

  • Multi-Specialty Clinic/Center
  • Waseca, MN
  • NPI 1518494251
  NPD

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

{
    "created_epoch": "1456876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603670400000",
    "number": "1023478146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "507-284-2511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 MOULTON AND PARSONS DR",
            "city": "SAINT JAMES",
            "state": "MN",
            "postal_code": "560815550",
            "telephone_number": "507-375-3261"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 1st St SW",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "MN",
            "postal_code": "559050001",
            "country_code": "US",
            "telephone_number": "507-284-2511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "KYLE",
        "middle_name": "ROBERT",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-02",
        "last_updated": "2020-10-26",
        "certification_date": "2020-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "CNP 4392",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "WI",
            "license": "6832-33",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MN",
            "license": "CNP 4392",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kelliott73454@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "1101 Moulton and Parsons Dr",
            "city": "Saint James",
            "state": "MN",
            "country_code": "US",
            "postal_code": "560815550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Dr. T.a. Pinke, Inc
• DRS Moulton & Parsons MD
• Eagle Lake Family Dentistry, PA (St. James Family Dentistry)
• Lindy C Eatwell, DO
• Darci Lee Eigenberg, R.T (R)
• Bridget Sue Forstrom, O.D.
• Norma L Garza
• Paige Marie Gernes-Sanchez Morales, PA-C
• Brigette Glienke
• Samantha Soaad Glotfelty, MD

• Nurse Practitioner in Saint James, MN
• Providers in Saint James, MN by specialty
• Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.