Katherine Anne Wolden, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

10624 Issued in MN

Practice address

5803 Neal Ave N
Oak Park Heights, MN 55082-2177

Phone

(651) 439-8807

Fax

(651) 439-0232

NPI assigned

Jul 8, 2009

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

Other names 1

• Katherine Anne Stiles Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Emily Program P C

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • St Paul, MN
  • NPI 1528165065
  Medicare reassignment NPD
• Infinite Health Collaborative, PA

  • Orthopaedic Surgery Physician
  • Bloomington, MN
  • NPI 1164474250
  NPD (past)
• Infinite Health Collaborative, PA

  • Durable Medical Equipment & Medical Supplies
  • River Falls, WI
  • NPI 1144608589
  NPD (past)

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

{
    "created_epoch": "1247011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435622400000",
    "number": "1255560553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5803 NEAL AVE N",
            "city": "OAK PARK HEIGHTS",
            "state": "MN",
            "postal_code": "550822177",
            "telephone_number": "651-439-8807",
            "fax_number": "651-439-0232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5803 NEAL AVE N",
            "city": "OAK PARK HEIGHTS",
            "state": "MN",
            "postal_code": "550822177",
            "telephone_number": "651-439-8807",
            "fax_number": "651-439-0232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLDEN",
        "first_name": "KATHERINE",
        "middle_name": "ANNE",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-08",
        "last_updated": "2015-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "2481-23",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "10624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHERINE",
            "last_name": "STILES",
            "middle_name": "ANNE",
            "credential": "PAC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Walgreen Co
• Walmart Inc.
• Douglas G Weiher, D.D.S.
• Nicholas Gregory Weiss, MD
• Fredrick C Wittleder, PA

• Physician Assistant in Oak Park Heights, MN
• Providers in Oak Park Heights, MN by specialty
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2015; 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.