Kerri Penke

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

16180 Hastings Ave SE
Prior Lake, MN 55372-9227

Phone

(952) 443-4600

NPI assigned

Apr 20, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1618876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618876800000",
    "number": "1215518311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4315 GOLF CLUB DR APT 6511",
            "city": "AUBURN",
            "state": "AL",
            "postal_code": "368305971",
            "telephone_number": "952-607-6479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16180 HASTINGS AVE SE",
            "city": "PRIOR LAKE",
            "state": "MN",
            "postal_code": "553729227",
            "telephone_number": "952-443-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENKE",
        "first_name": "KERRI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-20",
        "last_updated": "2021-04-20",
        "certification_date": "2021-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Student in an Organized Health Care Education/Training Program in Prior Lake, MN
• Providers in Prior Lake, MN by specialty
• Student in an Organized Health Care Education/Training Program in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2021; 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.