Kaitlyn Burke, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

LP7026 Issued in MN

Practice address

3800 Park Nicollet Blvd
St Louis Park, MN 55416-2527

Phone

(952) 993-3123

NPI assigned

Jul 6, 2022

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 IA, MN2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Clinical Psychologist

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Park Nicollet ClinicGroup PAC ID 7911819438, 1,778 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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
• Park Nicollet Clinic

  • Family Medicine Physician
  • Brooklyn Park, MN
  • NPI 1447668678
  NPD
• Integrative Counseling Solutions Inc.

  • Community/Behavioral Health Agency
  • West Des Moines, IA
  • NPI 1942437231
  NPD (past)

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

{
    "created_epoch": "1657065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715299200000",
    "number": "1295468452",
    "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": "3800 PARK NICOLLET BLVD",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554162527",
            "telephone_number": "952-993-3123"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3737 Woodland Ave Ste 425",
            "address_purpose": "LOCATION",
            "city": "West Des Moines",
            "state": "IA",
            "postal_code": "502661967",
            "country_code": "US",
            "telephone_number": "515-223-1630",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURKE",
        "first_name": "KAITLYN",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-06",
        "last_updated": "2024-05-10",
        "certification_date": "2024-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP7026",
            "primary": true
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Audrie Burge-Meyer
• Robert F Burgfechtel, MD
• Sandy Burk, OTR
• Burke Mays P.a.
• Emma Marie Burke, LGSW
• Suzanne Burnett
• Brooke J Burns, CD(DONA)
• Paige Burrell
• Amanda Burrill, OT
• Abigail Laurel Burris, MA, LMFT

• Psychologist in St Louis Park, MN
• Providers in St Louis Park, MN by specialty
• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 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.