NPIMap

Individual provider Active NPI

Kate Ellen Campion Pederson, PA-C

  • Physician Assistant
  • Cloquet, MN
National Provider Identifier
1366060683
Registry record updated Feb 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
14891 Issued in MN
Practice address
1413 Highway 33 S
Cloquet, MN 55720-2626
Phone
(218) 337-4000
NPI assigned
Jul 13, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 14891 MN Primary

Addresses

Primary practice location

1413 Highway 33 S
Cloquet, MN 55720-2626

Mailing address

400 E 3Rd St
Duluth, MN 55805-1951

Other names 1

  • Kate Ellen Campion Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, MN2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240417003411 WI Practitioner - Physician Assistant 4284073636 Reassigns benefits to 2 organizations
I20240418002453 MN Practitioner - Physician Assistant 4284073636 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Duluth Clinic LTDGroup PAC ID 2567374283, 1,135 clinicians
Polinsky Medical Rehabilitation CenterGroup PAC ID 0941377360, 369 clinicians

Practice addresses (Care Compare)

1413 Hwy 33 S
Cloquet, MN 55720-2626
Phone (218) 337-4000

1600 Miller Trunk Hwy
Duluth, MN 55811-5640
Phone (218) 786-5360

400 E 3Rd St
Duluth, MN 55805-1951
Phone (218) 786-8364

4212 Grand Ave
Duluth, MN 55807-2737
Phone (218) 786-3500

4855 W Arrowhead Rd
Hermantown, MN 55811-3936
Phone (218) 786-3540

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Duluth Clinic, LTD CurrentSince Apr 22, 2024 Accepting new patients
Essentia Health Moose Lake CurrentSince Apr 22, 2024 Accepting new patients
St. Mary'S Hospital of Superior CurrentSince Apr 22, 2024 Accepting new patients
Essentia Health Moose Lake CurrentSince Apr 22, 2024 Accepting new patients
The Duluth Clinic, LTD Current Accepting new patients
Moose Lake Community Hospital District Current Accepting new patients
The Duluth Clinic, LTD. CurrentSince Apr 22, 2024 Accepting new patients
St. Mary'S Hospital of Superior CurrentSince Jan 1, 2026 Accepting new patients
The Duluth Clinic, LTD Current Accepting new patients
Pine Medical Center CurrentSince Apr 22, 2024 Accepting new patients

Locations

1413 Highway 33 S
Cloquet, MN 55720
Phone (218) 337-4000

4212 Grand Ave
Duluth, MN 55807
Phone (218) 786-3500

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

4855 W Arrowhead Rd
Hermantown, MN 55811
Phone (218) 786-3540

4572 County Road 61
Moose Lake, MN 55767
Phone (218) 485-4481

705 Lundorff Dr
Sandstone, MN 55072
Phone (320) 245-2211

603 9th St N
Virginia, MN 55792
Phone (218) 741-3013

3500 Tower Ave
Superior, WI 54880
Phone (715) 392-8281

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1594598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738627200000",
    "number": "1366060683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1413 HIGHWAY 33 S",
            "city": "CLOQUET",
            "state": "MN",
            "postal_code": "557202626",
            "telephone_number": "218-337-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDERSON",
        "first_name": "KATE",
        "middle_name": "ELLEN CAMPION",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-13",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "14891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATE",
            "last_name": "CAMPION",
            "middle_name": "ELLEN",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cloquet, MN

Sources for this page

Verify at the official NPI Registry.