NPIMap

Individual provider Active NPI

Kathryn Joy Smith, CNP

  • Family Nurse Practitioner
  • Coon Rapids, MN
National Provider Identifier
1326803610
Registry record updated May 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11298 Issued in MN
Practice address
9055 Springbrook Dr NW
Coon Rapids, MN 55433-5841
Phone
(763) 780-9155
NPI assigned
Feb 16, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11298 MN Primary

Addresses

Primary practice location

9055 Springbrook Dr NW
Coon Rapids, MN 55433-5841

Mailing address

6075 409TH Ave NW
Dalbo, MN 55017-5110
Phone (612) 703-2097

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ksmith71778@excellian.direct.allina.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240306001656 MN Practitioner - Nurse Practitioner 3678919222 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians

Practice addresses (Care Compare)

103 Ctr Dr
Buffalo, MN 55313-2957
Phone (763) 684-3808

9055 Springbrook Dr NW
Coon Rapids, MN 55433-5841
Phone (763) 780-9155

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System CurrentSince Mar 30, 2024 Accepting new patients
Allina Health System Current Accepting new patients
Allina Health System CurrentSince Mar 30, 2024 Accepting new patients
Allina Health System Past Accepting new patients

Locations

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

103 Center Dr
Buffalo, MN 55313
Phone (763) 684-3807

303 Catlin St
Buffalo, MN 55313
Phone (763) 682-1212

303 Catlin St
Ste 100
Buffalo, MN 55313
Phone (763) 684-6160

755 Crossroads Campus Dr NE
Buffalo, MN 55313
Phone (763) 684-6300

303 Catlin St
Ste 10
Buffalo, MN 55313
Phone (763) 682-5225

701 Dellwood St S
Cambridge, MN 55008
Phone (763) 689-7700

9055 Springbrook Dr NW
Minneapolis, MN 55433
Phone (763) 780-9155

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

Organizations & group practices 4

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.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1708041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716940800000",
    "number": "1326803610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6075 409TH AVE NW",
            "city": "DALBO",
            "state": "MN",
            "postal_code": "550175110",
            "telephone_number": "612-703-2097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9055 SPRINGBROOK DR NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554335841",
            "telephone_number": "763-780-9155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KATHRYN",
        "middle_name": "JOY",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-16",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "11298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ksmith71778@excellian.direct.allina.com",
            "affiliation": "N",
            "endpointDescription": "ksmith71778@excellian.direct.allina.com",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "9055 Springbrook Dr NW",
            "city": "Coon Rapids",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554335841",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Coon Rapids, MN

Sources for this page

Verify at the official NPI Registry.