Individual provider Active NPI

Kelly Vevea

  • Family Nurse Practitioner
  • Elk River, MN
National Provider Identifier
1093268393
Registry record updated Aug 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2016018311 Issued in MN
Practice address
290 Main St NW
Elk River, MN 55330-1270
Phone
(612) 672-2986
NPI assigned
Aug 3, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 3, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2016018311 MN Primary

Addresses

Primary practice location

290 Main St NW
Elk River, MN 55330-1270

Mailing address

2605 Yukon Ave S
Saint Louis Park, MN 55426-2422

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
I20160919000980 MN Practitioner - Nurse Practitioner 3072800150 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fairview ClinicsGroup PAC ID 7113830142, 799 clinicians

Practice addresses (Care Compare)

2270 Ford Pkwy
Suite 200
Saint Paul, MN 55116-3412
Phone (651) 696-5000

Hospital & facility affiliations

  • Fairview Northland Regional Hospital Hospital, Princeton, MN, CCN 240141

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2016018311MNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Clinics CurrentSince Aug 12, 2016 Accepting new patients
Fairview Express Care Current Accepting new patients
Fairview Health Services CurrentSince Aug 12, 2016 Accepting new patients
Fairview Health Services Current Accepting new patients
Fairview Clinics CurrentSince Aug 12, 2016 Accepting new patients
Fairview Express Care CurrentSince Mar 27, 2021 Accepting new patients
Fairview Health Services Current Accepting new patients
Fairview Clinics Current Accepting new patients
Fairview Express Care CurrentSince Mar 27, 2021 Accepting new patients
Fairview Clinics Past Accepting new patients

Locations

14101 Fairview Dr
Ste 300
Burnsville, MN 55337
Phone (612) 273-5400

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

290 Main St NW
Elk River, MN 55330
Phone (763) 241-5800

290 Main St NW
Ste 100
Elk River, MN 55330
Phone (763) 241-0373

400 Stinson Blvd
Fl 2
Minneapolis, MN 55413
Phone (612) 672-2203

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

2270 Ford Pkwy
Ste 200
Saint Paul, MN 55116
Phone (651) 696-5000

Interoperability endpoints

  • Direct secure messaging: kvevea204867@fairview.direct-ci.com

Organizations & group practices 11

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.

Hospital & facility affiliations 2

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": "1470182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470182400000",
    "number": "1093268393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2605 YUKON AVE S",
            "city": "SAINT LOUIS PARK",
            "state": "MN",
            "postal_code": "554262422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 MAIN ST NW",
            "city": "ELK RIVER",
            "state": "MN",
            "postal_code": "553301270",
            "telephone_number": "612-672-2986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEVEA",
        "first_name": "KELLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-03",
        "last_updated": "2016-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "2016018311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk River, MN

Sources for this page

Verify at the official NPI Registry.