Karissa Remer

Primary specialty

DentistTaxonomy code 122300000X

License

D14043 Issued in MN

Practice address

13000 Technology Dr
Eden Prairie, MN 55344-3606

Phone

(952) 562-1463

NPI assigned

Jul 10, 2018

Last updated

Jul 10, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Karissa Clark Professional name

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1531180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531180800000",
    "number": "1558857714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13000 TECHNOLOGY DR",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553443606",
            "telephone_number": "952-562-1463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13000 TECHNOLOGY DR",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553443606",
            "telephone_number": "952-562-1463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REMER",
        "first_name": "KARISSA",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-10",
        "last_updated": "2018-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D14043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KARISSA",
            "last_name": "CLARK",
            "prefix": "DR.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Kenneth F. Reed, PH.D.
• Jonathan-Erle Christian Reid
• Andrea Reinardy
• Amber Reis, LMFT
• Reliable Ride LLC
• Renal Treatment Centers-Illinois Inc (Eden Prairie Dialysis)
• Renewal MN LLC (Renewal Rehab)
• Rachel Rhyner
• Lionel Wayne Rice Jr., ATC
• Mavis Rice, MA LP

• Dentist in Eden Prairie, MN
• Providers in Eden Prairie, MN by specialty
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.