Individual provider Active NPI

Kristen Rae Petterson, CNP

  • Family Nurse Practitioner
  • Austin, MN
National Provider Identifier
1427652908
Registry record updated Mar 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
7925 Issued in MN
Practice address
1000 1St Dr NW
Austin, MN 55912-2941
Phone
(507) 433-7351
NPI assigned
Nov 25, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 7925 MN
Family Nurse Practitioner 363LF0000X 7925 MN Primary

Addresses

Primary practice location

1000 1St Dr NW
Austin, MN 55912-2941

Mailing address

1000 1St Dr NW
Austin, MN 55912-2941
Phone (507) 433-7351

Other names 1

  • Kristen Rae Leonhardi Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kleonhardi89269@ehrdirect.mayoclinicmsg.org

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
I20210104001697 MN Practitioner - Nurse Practitioner 2062825490 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

404 W Fountain St
Albert Lea, MN 56007-2437
Phone (507) 373-2384

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7925MNMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Health System-Southeast Minnesota Region CurrentSince Jan 20, 2021 Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region CurrentSince Jan 20, 2021 Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region Current Accepting new patients

Locations

404 W Fountain St
Albert Lea, MN 56007
Phone (507) 377-6285

1000 1st Dr NW
Austin, MN 55912
Phone (507) 433-7351

Organizations & group practices 3

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 1

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": "1606262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648684800000",
    "number": "1427652908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 1ST DR NW",
            "city": "AUSTIN",
            "state": "MN",
            "postal_code": "559122941",
            "telephone_number": "507-433-7351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 1ST DR NW",
            "city": "AUSTIN",
            "state": "MN",
            "postal_code": "559122941",
            "telephone_number": "507-433-7351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTERSON",
        "first_name": "KRISTEN",
        "middle_name": "RAE",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-25",
        "last_updated": "2022-03-31",
        "certification_date": "2022-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "7925",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "7925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kleonhardi89269@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "1000 1st Dr NW",
            "city": "Austin",
            "state": "MN",
            "country_code": "US",
            "postal_code": "559122941",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "LEONHARDI",
            "middle_name": "RAE",
            "credential": "CNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Austin, MN

Sources for this page

Verify at the official NPI Registry.