Individual provider Active NPI

Kimberly A Walsh, NP

  • Nurse Practitioner
  • St Louis Park, MN
National Provider Identifier
1427341247
Registry record updated Feb 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
CNP2078 Issued in MN
Practice address
3931 Louisiana Ave S
St Louis Park, MN 55426-5000
Phone
(952) 993-3248
NPI assigned
May 26, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R158402-0 MN
Nurse Practitioner 363L00000X CNP2078 MN Primary

Addresses

Primary practice location

3931 Louisiana Ave S
St Louis Park, MN 55426-5000

Mailing address

3931 Louisiana Ave S
St Louis Park, MN 55426-5000
Phone (952) 993-3248

Other practice location 1

424 Harvard St SE
University of Minnesota Physicians
Minneapolis, MN 55455
Phone (612) 624-2620

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111116000883 MN Practitioner - Nurse Practitioner 8729252333 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
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)

5320 Hyland Greens Dr
Bloomington, MN 55437-3934
Phone (952) 993-2400

6500 Excelsior Blvd
St Louis Park, MN 55426-4702
Phone (952) 993-3123

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
CNP2078MNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Express Care CurrentSince Mar 1, 2020 Accepting new patients
Fairview Health Services Current Accepting new patients
Fairview Health Services CurrentSince Sep 14, 2011 Accepting new patients
Park Nicollet Clinic CurrentSince Mar 22, 2021 Accepting new patients
Fairview Express Care CurrentSince Sep 14, 2011 Accepting new patients
Park Nicollet Clinic CurrentSince Mar 22, 2021 Accepting new patients
Fairview Express Care CurrentSince Mar 1, 2020 Accepting new patients
Fairview Express Care Current Accepting new patients

Locations

14101 Fairview Dr
Ste 300
Burnsville, MN 55337
Phone (612) 273-5400

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

516 Delaware St SE
Minneapolis, MN 55455
Phone (612) 625-3600

5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

500 Harvard St SE
Minneapolis, MN 55455
Phone (612) 273-7300

420 Delaware St SE
#126
Minneapolis, MN 55455
Phone (612) 626-2378

2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838

424 Harvard St SE
Minneapolis, MN 55455
Phone (612) 273-5700

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

3931 Louisiana Ave S
St Louis Park, MN 55426
Phone (952) 993-3230

Organizations & group practices 9

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 6

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": "1306368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612396800000",
    "number": "1427341247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3931 LOUISIANA AVE S",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554265000",
            "telephone_number": "952-993-3248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3931 LOUISIANA AVE S",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554265000",
            "telephone_number": "952-993-3248"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "424 Harvard St SE",
            "address_2": "University of Minnesota Physicians",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "55455",
            "country_code": "US",
            "telephone_number": "612-624-2620",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALSH",
        "first_name": "KIMBERLY",
        "middle_name": "A",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-26",
        "last_updated": "2021-02-04",
        "certification_date": "2021-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "R158402-0",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "CNP2078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Louis Park, MN

Sources for this page

Verify at the official NPI Registry.