Kristina Ann Bohm, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

2081 Issued in MN

Practice address

4155 County Road 101 N
Plymouth, MN 55446-2307

Phone

(952) 993-8900

NPI assigned

Jul 24, 2012

Sex

Female

Sole proprietor

No

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Park Nicollet ClinicGroup PAC ID 7911819438, 1,778 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Park Nicollet Methodist Hospital Hospital, Saint Louis Park, MN, CCN 240053

Medicare enrollment (NPD)

Enrolled

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
  Medicare reassignment Care Compare group NPD
• Park Nicollet Clinic

  • Family Medicine Physician
  • St Louis Park, MN
  • NPI 1063897593
  NPD
• Big Lake Spine & Sport, PA

  dba Great River Spine & Sport

  • Chiropractor
  • Monticello, MN
  • NPI 1295747889
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Park Nicollet Methodist Hospital

  • General Acute Care Hospital
  • Maple Grove, MN
  • NPI 1174980692
  Care Compare affiliation
• Park Nicollet Methodist Hospital

  dba Park Nicollet Methodist Hospital Outpatient Surgery Center

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

  dba PN Methodist Hospital Episodic Bundle

  • General Acute Care Hospital
  • St Louis Park, MN
  • NPI 1245615772
  Care Compare affiliation
• Park Nicollet Methodist Hospital

  dba Park Nicollet Melrose Center

  • Mental Illness Community Based Residential Treatment Facility
  • St Louis Park, MN
  • NPI 1578717336

  Hospital

  Care Compare affiliation
• Park Nicollet Methodist Hospital

  • General Acute Care Hospital
  • St Louis Park, MN
  • NPI 1649220724
  Care Compare affiliation
• Park Nicollet Methodist Hospital

  dba Park Nicollet Melrose Center

  • General Acute Care Hospital
  • St Louis Park, MN
  • NPI 1942585286
  Care Compare affiliation

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

{
    "created_epoch": "1343088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723161600000",
    "number": "1194071449",
    "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": "4155 COUNTY ROAD 101 N",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554462307",
            "telephone_number": "952-993-8900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30 7th Ave S",
            "address_purpose": "LOCATION",
            "city": "Saint Cloud",
            "state": "MN",
            "postal_code": "563014213",
            "country_code": "US",
            "telephone_number": "216-404-8436",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOHM",
        "first_name": "KRISTINA",
        "middle_name": "ANN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-24",
        "last_updated": "2024-08-09",
        "certification_date": "2024-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "R182757-0",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "2081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teresa A Boatman, PHD, LP
• Marissa Hurd Bodiker, MS, CCC-SLP
• Paul D Boettner, D.D.S.
• Trayvaughn Bogard-Merrick
• Chad E Boger, D.D.S.
• Melissa Ann Bollinger-Kinney, M.S.ED LPC
• Helaine Bolter, PSY.D, LP
• Tom Bomberg, D.C.
• Marla Bookhout, PT
• Emma Kathleen Boone, PA

• Nurse Practitioner in Plymouth, MN
• Providers in Plymouth, MN by specialty
• Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.