Active NPI
Kim Marie Keil
- Licensed Practical Nurse
- Waite Park, MN
National Provider Identifier
1295207728
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- L0399863
- Practice address
- 742 1St St S Ste 105
Waite Park, MN 56387-1315 - Phone
- (320) 240-6869
- Fax
- (320) 251-0358
- NPI assigned
- Dec 21, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | L0399863 | MN | Primary |
Addresses
Primary practice location
742 1St St S Ste 105
Waite Park, MN 56387-1315
Mailing address
742 1St St S Ste 105
Waite Park, MN 56387-1315
Phone (320) 240-6869
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L0399863 | MN | MD | Licensed Practical Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tru Healthcare, Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- In Home Supportive Care Agency
- Arden Hills, MN
- NPI 1982702932
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1545350400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1545350400000",
"number": "1295207728",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "742 1ST ST S STE 105",
"city": "WAITE PARK",
"state": "MN",
"postal_code": "563871315",
"telephone_number": "320-240-6869",
"fax_number": "320-251-0358"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "742 1ST ST S STE 105",
"city": "WAITE PARK",
"state": "MN",
"postal_code": "563871315",
"telephone_number": "320-240-6869",
"fax_number": "320-251-0358"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEIL",
"first_name": "KIM",
"middle_name": "MARIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-12-21",
"last_updated": "2018-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "MN",
"license": "L0399863",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waite Park, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.