Active NPI
Kevin Wahlberg
- Driver
- Sandstone, MN
National Provider Identifier
1306767918
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Driver
- License
- Y275218560914
- Practice address
- 55123 W Grindstone Rd
Sandstone, MN 55072-2692 - Phone
- (320) 385-4477
- Fax
- (320) 216-7638
- NPI assigned
- Jul 22, 2026
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Driver | 172A00000X | Y275218560914 | MN | Primary |
Addresses
Primary practice location
55123 W Grindstone Rd
Sandstone, MN 55072-2692
Mailing address
55123 W Grindstone Rd
Sandstone, MN 55072-2692
Phone (320) 385-4477
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1784678400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1784678400000",
"number": "1306767918",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "55123 W GRINDSTONE RD",
"city": "SANDSTONE",
"state": "MN",
"postal_code": "550722692",
"telephone_number": "320-385-4477",
"fax_number": "320-216-7638"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55123 W GRINDSTONE RD",
"city": "SANDSTONE",
"state": "MN",
"postal_code": "550722692",
"telephone_number": "320-385-4477",
"fax_number": "320-216-7638"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAHLBERG",
"first_name": "KEVIN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2026-07-22",
"last_updated": "2026-07-22",
"certification_date": "2026-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "172A00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Driver",
"state": "MN",
"license": "Y275218560914",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sandstone, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.