Individual provider Active NPI

Kimberly Mary Staebell, NP-C

  • Nurse Practitioner
  • Mankato, MN
National Provider Identifier
1083284277
Registry record updated May 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
9612 Issued in MN
Practice address
1025 Marsh St
Mankato, MN 56001-4752
Phone
(507) 625-4031
NPI assigned
Jun 29, 2021
Last updated
May 15, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X A164641 IA
Nurse Practitioner 363L00000X 9612 MN Primary
Registered Nurse 163W00000X R039896 SD

Addresses

Primary practice location

1025 Marsh St
Mankato, MN 56001-4752

Mailing address

1025 Marsh St
Mankato, MN 56001-4752
Phone (507) 625-4031

Other practice location 1

801 E Libby Ln
Sioux Falls, SD 57108-4658
Phone (605) 299-6252

Other practice location 2

801 5th St
Sioux City, IA 51101-1326
Phone (712) 279-2010

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kstaebell1781562@ehrdirect.mayoclinicmsg.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, NC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20221103000146 MN Practitioner - Nurse Practitioner 5092182139 Reassigns benefits to 13 organizations
I20250424002277 NC Practitioner - Nurse Practitioner 5092182139 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mayo Clinic Health System-Southwest Minnesota RegionGroup PAC ID 4688585771, shared by 6 NPIs, 658 clinicians

Practice addresses (Care Compare)

1025 Marsh St
Mankato, MN 56001-4752
Phone (507) 625-4031

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R039896SDMDRegistered Nurse
9612MNMDPhysician Assistant
A164641IAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Health System-St James CurrentSince Oct 20, 2022 Accepting new patients
Apogee Medical Group North Carolina CurrentSince Apr 17, 2025 Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region CurrentSince Dec 1, 2025 Accepting new patients
St. Luke's Hospital of Duluth CurrentSince Apr 1, 2025 Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region Current Accepting new patients
St. Luke's Hospital of Duluth CurrentSince Apr 1, 2025 Accepting new patients
Mayo Clinic Health System-Lake City CurrentSince Dec 1, 2025 Accepting new patients
International Falls Memorial Hospital Association CurrentSince Mar 30, 2024 Accepting new patients
Mayo Clinic Health System-Fairmont CurrentSince Oct 20, 2022 Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region CurrentSince Dec 1, 2025 Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region CurrentSince Oct 20, 2022 Accepting new patients
International Falls Memorial Hospital Association CurrentSince Mar 30, 2024 Accepting new patients
Mayo Clinic Health System-Lake City CurrentSince Dec 1, 2025 Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region CurrentSince Oct 20, 2022 Accepting new patients
Mayo Clinic Health System-St James Current Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region CurrentSince Dec 1, 2025 Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region Current Accepting new patients
St. Luke's Hospital of Duluth Current Accepting new patients
St. Luke's Hospital of Duluth Past Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

404 W Fountain St
Albert Lea, MN 56007
Phone (507) 377-6285

1000 1st Dr NW
Austin, MN 55912
Phone (507) 433-7351

32021 County 24 Blvd
Cannon Falls, MN 55009
Phone (507) 263-6000

1015 E 1st St
Duluth, MN 55805
Phone (218) 249-7860

915 E 1st St
Duluth, MN 55805
Phone (218) 249-5352

800 Medical Center Dr
Fairmont, MN 56031
Phone (507) 238-8100

1400 Highway 71
Intl Falls, MN 56649
Phone (218) 283-4481

500 W Grant St
Lake City, MN 55041
Phone (651) 345-3321

1025 Marsh St
Mankato, MN 56001
Phone (507) 345-2623

301 2nd St NE
New Prague, MN 56071
Phone (952) 758-4431

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

1101 Moulton and Parsons Dr
Saint James, MN 56081
Phone (507) 375-3261

501 State St N
Waseca, MN 56093
Phone (507) 781-8176

317 Western Blvd
Jacksonville, NC 28546
Phone (910) 577-2240

615 Ridge Rd
Roxboro, NC 27573
Phone (336) 503-5699

Interoperability endpoints

  • Direct secure messaging: kstaebell1781562@ehrdirect.mayoclinicmsg.org

Organizations & group practices 20

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.

View all 20

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1624924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747267200000",
    "number": "1083284277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 MARSH ST",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560014752",
            "telephone_number": "507-625-4031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 MARSH ST",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560014752",
            "telephone_number": "507-625-4031"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "801 E Libby Ln",
            "address_purpose": "LOCATION",
            "city": "Sioux Falls",
            "state": "SD",
            "postal_code": "571084658",
            "country_code": "US",
            "telephone_number": "605-299-6252",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "801 5th St",
            "address_purpose": "LOCATION",
            "city": "Sioux City",
            "state": "IA",
            "postal_code": "511011326",
            "country_code": "US",
            "telephone_number": "712-279-2010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STAEBELL",
        "first_name": "KIMBERLY",
        "middle_name": "MARY",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-29",
        "last_updated": "2025-05-15",
        "certification_date": "2025-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IA",
            "license": "A164641",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "9612",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "SD",
            "license": "R039896",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kstaebell1781562@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "1025 Marsh St",
            "city": "Mankato",
            "state": "MN",
            "country_code": "US",
            "postal_code": "560014752",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mankato, MN

Sources for this page

Verify at the official NPI Registry.