Kelsey Bergstrom Ankeny, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

58882 Issued in MN

Practice address

6500 Excelsior Blvd
St Louis Park, MN 55426-4702

Phone

(952) 993-5000

NPI assigned

Jun 5, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Park Nicollet Clinic

  • Family Medicine Physician
  • St Louis Park, MN
  • NPI 1780621904

  Pediatrics

  Medicare reassignment NPD
• Park Nicollet Clinic

  • Family Medicine Physician
  • St Louis Park, MN
  • NPI 1063897593

  Pediatrics

  NPD
• Park Nicollet Methodist Hospital

  • General Acute Care Hospital
  • St Louis Park, MN
  • NPI 1194113217
  NPD
• Park Nicollet Methodist Hospital

  • General Acute Care Hospital
  • St Louis Park, MN
  • NPI 1649220724
  NPD (past)

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

{
    "created_epoch": "1338854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732147200000",
    "number": "1134480254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S # MS 21110Q",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554254516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 EXCELSIOR BLVD",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554264702",
            "telephone_number": "952-993-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4050 Coon Rapids Blvd NW",
            "address_purpose": "LOCATION",
            "city": "Coon Rapids",
            "state": "MN",
            "postal_code": "554332522",
            "country_code": "US",
            "telephone_number": "763-236-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANKENY",
        "first_name": "KELSEY",
        "middle_name": "BERGSTROM",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-05",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "58882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katie Lynn Andrinas, MD, MPH
• Mary Catherine Andros, P.T.
• Sydney Rae Angel
• Angelicare LLC
• Elizabeth A Angermeyr, M.D.
• Anod Inc
• Onaiza Ansar, MBBS
• Christina Cathryn Apfelbaum, P.T., D.P.T.
• Andrew Charles Appel, MS
• Apple Group Home Inc.

• Pediatrics Physician in St Louis Park, MN
• Providers in St Louis Park, MN by specialty
• Pediatrics Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.