Individual provider Active NPI

Kari Annette Baillif

  • Primary Care Nurse Practitioner
  • Saint Paul, MN
National Provider Identifier
1073021184
Registry record updated Nov 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
AG12170092 Issued in MN
Practice address
2004 Ford Pkwy
Saint Paul, MN 55116-1931
Phone
(612) 256-8225
NPI assigned
Jan 11, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X AG12170092 MN Primary

Addresses

Primary practice location

2004 Ford Pkwy
Saint Paul, MN 55116-1931

Mailing address

121 Washington Ave N FL 2
Minneapolis, MN 55401-1619
Phone (888) 731-8994

Other practice location 1

121 Washington Ave N Fl 2
Minneapolis, MN 55401-1619
Phone (888) 731-8994

Other identifiers 1

IdentifierTypeStateIssuer
AG12170092MedicaidMN

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
I20180410000582 MN Practitioner - Nurse Practitioner 1456614296 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1406 6TH Ave No
St Cloud, MN 56303-1901

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5693MNMDOccupational Therapist
AG12170092MNMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Centracare Clinic Current Accepting new patients
Herself Health MN PC Primary Care CurrentSince Jan 5, 2026 Accepting new patients
Integrative Womens Care PC Past Accepting new patients

Locations

1200 6th Ave N
Saint Cloud, MN 56303
Phone (320) 252-3342

1900 Centracare Cir
Saint Cloud, MN 56303
Phone (320) 252-2422

2004 Ford Pkwy
Saint Paul, MN 55116
Phone (612) 256-8225

Interoperability endpoints

  • Direct secure messaging: kari.baillif.1@27069.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/31254/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1515628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763942400000",
    "number": "1073021184",
    "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": "554011619",
            "telephone_number": "888-731-8994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2004 FORD PKWY",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551161931",
            "telephone_number": "612-256-8225"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "121 Washington Ave N Fl 2",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554011619",
            "country_code": "US",
            "telephone_number": "888-731-8994",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAILLIF",
        "first_name": "KARI",
        "middle_name": "ANNETTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-11",
        "last_updated": "2025-11-24",
        "certification_date": "2025-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MN",
            "license": "AG12170092",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "AG12170092",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.