Individual provider Active NPI

Kelsey Nicole Parks, MD

  • Pediatrics Physician
  • Edina, MN
National Provider Identifier
1093396103
Registry record updated Sep 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
77153 Issued in MN
Practice address
3955 Parklawn Ave Ste 120
Edina, MN 55435-5660
Phone
(952) 278-7000
Fax
(952) 278-6942
NPI assigned
Apr 20, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 77153 MN Primary

Addresses

Primary practice location

3955 Parklawn Ave Ste 120
Edina, MN 55435-5660

Mailing address

3955 Parklawn Ave Ste 120
Edina, MN 55435-5660
Phone (952) 278-7000

Other names 1

  • Kelsey Nicole Hoegh Former name

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
77153MNMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southdale Pediatric Associates, LTD CurrentSince Sep 1, 2024 Accepting new patients
Fairview Health Services Past Accepting new patients

Locations

501 E Nicollet Blvd
Ste 200
Burnsville, MN 55337
Phone (952) 278-7000

11095 Viking Dr
Ste 250
Eden Prairie, MN 55344
Phone (952) 278-7000

3955 Parklawn Ave
Ste 120
Minneapolis, MN 55435
Phone (952) 278-7000

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/1846cf9e-8006-4277-b72f-3cbbe8a8f5ca/

Organizations & group practices 2

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": "1618876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727308800000",
    "number": "1093396103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3955 PARKLAWN AVE STE 120",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554355660",
            "telephone_number": "952-278-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3955 PARKLAWN AVE STE 120",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554355660",
            "telephone_number": "952-278-7000",
            "fax_number": "952-278-6942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKS",
        "first_name": "KELSEY",
        "middle_name": "NICOLE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-20",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "77153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELSEY",
            "last_name": "HOEGH",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Edina, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 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.

Verify at the official NPI Registry.