Serene Medical Clinic LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

SERENE MEDICAL CLINIC LLC

Practice address

4470 W 78TH Street Cir Ste 265
Bloomington, MN 55435-5408

Phone

(952) 260-3367

Fax

(952) 213-4260

NPI assigned

May 2, 2025

Organization subpart

No

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

Authorized official

Name

Fartun Ahmed Keynan, APRN, FNP, PMHNPNPI 1255119087

Title

Nurse Practitioner

Phone

(952) 260-3367

Specialties & licenses 1

Addresses

Other names 1

• Serene Medical Clinic LLC: Doing business as

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Fartun Ahmed Keynan, FNP, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Bloomington, MN
  • NPI 1255119087

  Multi-Specialty

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1746144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767312000000",
    "number": "1134918550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4470 W 78TH STREET CIR STE 265",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554355408",
            "telephone_number": "952-260-3367",
            "fax_number": "952-213-4260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4470 W 78TH STREET CIR STE 265",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554355408",
            "telephone_number": "952-260-3367",
            "fax_number": "952-213-4260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENE MEDICAL CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-02",
        "last_updated": "2026-01-02",
        "certification_date": "2026-01-02",
        "status": "A",
        "authorized_official_last_name": "KEYNAN",
        "authorized_official_first_name": "FARTUN",
        "authorized_official_middle_name": "AHMED",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "952-260-3367",
        "authorized_official_credential": "APRN, FNP, PMHNP"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Serene Medical Clinic LLC:",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Psychiatry Physician in Bloomington, MN
• Providers in Bloomington, MN by specialty
• Psychiatry Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.