Individual provider Active NPI

Kelsey Lucia Sjogren, APRN, CNP

  • Pediatric Nurse Practitioner
  • Minneapolis, MN
National Provider Identifier
1124517511
Registry record updated Oct 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
5679 Issued in MN
Practice address
2512 S 7TH St
Minneapolis, MN 55454-1404
Phone
(320) 761-8170
NPI assigned
May 1, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 5679 MN Primary

Addresses

Primary practice location

2512 S 7TH St
Minneapolis, MN 55454-1404

Mailing address

PO Box 2010
Fargo, ND 58122-2484

Other practice location 1

701 Park Ave
Minneapolis, MN 55415-1623
Phone (612) 873-3000

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
I20190228000001 MN Practitioner - Nurse Practitioner 4587903091 Reassigns benefits to 5 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5679MNMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Minnesota Physicians CurrentSince Dec 1, 2025 Accepting new patients
Hennepin Healthcare System Inc CurrentSince Mar 20, 2020 Accepting new patients
Fairview Express Care CurrentSince Mar 7, 2020 Accepting new patients
Fairview Health Services Current Accepting new patients
University of Minnesota Physicians Current Accepting new patients
Hennepin Healthcare System, Inc Current Accepting new patients
Fairview Express Care CurrentSince May 1, 2020 Accepting new patients
Fairview Express Care CurrentSince May 1, 2020 Accepting new patients
Fairview Express Care Current Accepting new patients
Fairview Health Services CurrentSince Mar 7, 2020 Accepting new patients
Hennepin Healthcare System, Inc CurrentSince Mar 20, 2020 Accepting new patients

Locations

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

2512 S 7th St
Minneapolis, MN 55454
Phone (612) 273-4277

701 25th Ave S
Ste 200
Minneapolis, MN 55454
Phone (612) 339-2836

2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838

500 Harvard St SE
Minneapolis, MN 55455
Phone (612) 273-7300

701 Park Ave
Minneapolis, MN 55415
Phone (612) 873-6005

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

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

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

Interoperability endpoints

  • Direct secure messaging: ksjogren499877@fairview.direct-ci.com

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1525132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697068800000",
    "number": "1124517511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2010",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581222484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2512 S 7TH ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554541404",
            "telephone_number": "320-761-8170"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 Park Ave",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554151623",
            "country_code": "US",
            "telephone_number": "612-873-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SJOGREN",
        "first_name": "KELSEY",
        "middle_name": "LUCIA",
        "credential": "APRN, CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-01",
        "last_updated": "2023-10-12",
        "certification_date": "2023-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MN",
            "license": "5679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.