Individual provider Active NPI

Kimberly Steward

  • Community Health Worker
  • Brooklyn Park, MN
National Provider Identifier
1366189607
Registry record updated May 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
Practice address
5920 65TH Ave N Apt 155
Brooklyn Park, MN 55429-4311
Phone
(612) 707-4793
NPI assigned
May 18, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 18, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse's AideGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 376K00000X
Community Health Worker 172V00000X Primary

Addresses

Primary practice location

5920 65TH Ave N Apt 155
Brooklyn Park, MN 55429-4311

Mailing address

5920 65TH Ave N Apt 155
Brooklyn Park, MN 55429-4311
Phone (612) 707-4793

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": "1652832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652832000000",
    "number": "1366189607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5920 65TH AVE N APT 155",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554294311",
            "telephone_number": "612-707-4793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5920 65TH AVE N APT 155",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554294311",
            "telephone_number": "612-707-4793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWARD",
        "first_name": "KIMBERLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-18",
        "last_updated": "2022-05-18",
        "certification_date": "2022-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse's Aide",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn Park, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.