Elmer Harold Kasperson, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

22178 Issued in MN

Practice address

1500 Curve Crest Blvd W
Stillwater, MN 55082-6040

Phone

(651) 439-1234

Fax

(651) 351-0827

NPI assigned

Dec 5, 2005

Reactivated

Dec 6, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1133740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323129600000",
    "number": "1477537272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 CURVE CREST BLVD W",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550826040",
            "telephone_number": "651-439-1234",
            "fax_number": "651-439-1547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 CURVE CREST BLVD W",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550826040",
            "telephone_number": "651-439-1234",
            "fax_number": "651-351-0827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASPERSON",
        "first_name": "ELMER",
        "middle_name": "HAROLD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-05",
        "last_updated": "2011-12-06",
        "deactivation_date": "2011-08-30",
        "reactivation_date": "2011-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MN",
            "license": "22178",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "186303700",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30282500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ingrid Bwahama Kaijage, M.D.
• Kristen M Kajewski, DO
• Stephanie Summer Kalliman
• Sarah M Kane, PA-C
• Lance Kansas, MD
• Jesse Katzman, L.AC.
• Julie Anne Kaufman, MA, LPC, RYT-200
• Kari Kelcher, LMFT
• Michelle Marie Kellum, LADC
• John Curtis Kelly, PA-C

• Surgery Physician in Stillwater, MN
• Providers in Stillwater, MN by specialty
• Surgery Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2011; 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.