NPIMap

Individual provider Active NPI

Kimberly Sue Weber

  • Primary Care Nurse Practitioner
  • Burnsville, MN
National Provider Identifier
1568239051
Registry record updated Dec 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
AG09230115 Issued in MN
Practice address
303 E Nicollet Blvd
Burnsville, MN 55337-4522
Phone
(952) 250-2871
NPI assigned
Dec 5, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X AG09230115 MN
Adult Health Nurse Practitioner 363LA2200X AG09230115 MN
Gerontology Nurse Practitioner 363LG0600X AG09230115 MN
Primary Care Nurse Practitioner 363LP2300X AG09230115 MN Primary

Addresses

Primary practice location

303 E Nicollet Blvd
Burnsville, MN 55337-4522

Mailing address

17040 Glenwood Ave
Lakeville, MN 55044-7416
Phone (952) 250-2871

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240220003008 MN Practitioner - Nurse Practitioner 4183068950 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fairview ClinicsGroup PAC ID 7113830142, 799 clinicians

Practice addresses (Care Compare)

303 E Nicollet Blvd
Suite 160
Burnsville, MN 55337-4588
Phone (952) 460-4000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AG09230115MNMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Clinics Current Accepting new patients
Fairview Health Services CurrentSince Feb 15, 2024 Accepting new patients
Fairview Clinics CurrentSince Feb 15, 2024 Accepting new patients
Fairview Clinics CurrentSince Feb 15, 2024 Accepting new patients
Fairview Health Services CurrentSince Feb 15, 2024 Accepting new patients
Fairview Health Services Current Accepting new patients
Fairview Clinics Past Accepting new patients

Locations

303 E Nicollet Blvd
Burnsville, MN 55337
Phone (952) 460-4000

303 E Nicollet Blvd
Ste 160
Burnsville, MN 55337
Phone (952) 460-4000

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

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

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

1700 University Ave W
Saint Paul, MN 55104
Phone (612) 672-6740

Interoperability endpoints

  • Direct secure messaging: kweber715104@fairview.direct-ci.com

Organizations & group practices 7

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 9

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": "1701734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701734400000",
    "number": "1568239051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17040 GLENWOOD AVE",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550447416",
            "telephone_number": "952-250-2871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 E NICOLLET BLVD",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553374522",
            "telephone_number": "952-250-2871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBER",
        "first_name": "KIMBERLY",
        "middle_name": "SUE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-05",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "AG09230115",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MN",
            "license": "AG09230115",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MN",
            "license": "AG09230115",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MN",
            "license": "AG09230115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burnsville, MN

Sources for this page

Verify at the official NPI Registry.