Individual provider Active NPI

Kae B Loverink, M.D.

  • Family Medicine Physician
  • Saint Peter, MN
National Provider Identifier
1467418681
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD159669 Issued in OR
Practice address
1900 Sunrise Dr
Saint Peter, MN 56082-5376
Phone
(507) 934-7312
Fax
(507) 934-8516
NPI assigned
Apr 25, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 35537 CO
Family Medicine Physician 207Q00000X MD159669 OR Primary

Addresses

Primary practice location

1900 Sunrise Dr
Saint Peter, MN 56082-5376

Mailing address

PO Box 5723
Bend, OR 97708-5723
Phone (702) 453-3799

Other practice location 1

94220 4th St
Gold Beach, OR 97444-7756
Phone (541) 247-3160

Other identifiers 1

IdentifierTypeStateIssuer
01355379MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110208000342 CO Practitioner - Family Practice 8426238478 Practice locations: Craig, CO

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35537COMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1467418681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5723",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977085723",
            "telephone_number": "702-453-3799",
            "fax_number": "702-453-5741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 SUNRISE DR",
            "city": "SAINT PETER",
            "state": "MN",
            "postal_code": "560825376",
            "telephone_number": "507-934-7312",
            "fax_number": "507-934-8516"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "94220 4th St",
            "address_purpose": "LOCATION",
            "city": "Gold Beach",
            "state": "OR",
            "postal_code": "974447756",
            "country_code": "US",
            "telephone_number": "541-247-3160",
            "fax_number": "541-247-3104",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOVERINK",
        "first_name": "KAE",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-25",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "35537",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD159669",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01355379",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Peter, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.