NPIMap

Individual provider Active NPI

Kimberly Benning, FNP

  • Family Nurse Practitioner
  • Duluth, MN
National Provider Identifier
1619301975
Registry record updated Jan 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
6421 Issued in MN
Practice address
4190 Loberg Ave
Duluth, MN 55811
Phone
(218) 249-5700
Fax
(218) 249-4666
NPI assigned
Aug 22, 2013
Sex
Female
Sole proprietor
Yes

Organizations & group practices 15

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 26

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 26

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. Luke'S Hospital of Duluth 409 clinicians

Practice addresses (Care Compare)

109 N 28TH St E
Superior, WI 54880-6548
Phone (715) 395-3900

4190 Loberg Ave
Duluth, MN 55811-2652
Phone (218) 249-4600

Hospital & facility affiliations

  • St Lukes Hospital Hospital, Duluth, MN, CCN 240047

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND, WI, MN3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Medicare enrollment records 3

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20131127000298 ND Practitioner - Nurse Practitioner 1850527631 Reassigns benefits to 1 organization
I20190514002826 WI Practitioner - Nurse Practitioner 1850527631 Reassigns benefits to 1 organization
I20190514003296 MN Practitioner - Nurse Practitioner 1850527631 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke'S Hospital of Duluth Current Accepting new patients
St. Luke'S Hospital of Duluth CurrentSince May 8, 2019 Accepting new patients
St. Luke'S Hospital of Duluth CurrentSince May 6, 2019 Accepting new patients
Presentation Medical Center CurrentSince Sep 11, 2013 Accepting new patients
Presentation Medical Center CurrentSince Sep 11, 2013 Accepting new patients
St. Luke'S Hospital of Duluth CurrentSince May 6, 2019 Accepting new patients
St. Luke'S Hospital of Duluth Past Accepting new patients
Presentation Medical Center Past Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

1400 Woodland Ave
Duluth, MN 55803
Phone (218) 249-8800

1015 E 1st St
Duluth, MN 55805
Phone (218) 249-7860

915 E 1st St
Duluth, MN 55805
Phone (218) 249-5352

4702 Grand Ave
Duluth, MN 55807
Phone (218) 249-6800

4190 Loberg Ave
Hermantown, MN 55811
Phone (218) 249-4600

109 N 28th St E
Superior, WI 54880
Phone (715) 395-3900

Interoperability endpoints

  • Direct secure messaging: kbenning352047@direct.aspirus.org

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 6421 MN Primary

Addresses

NPPES NPI Registry

Primary practice location

4190 Loberg Ave
Duluth, MN 55811

Mailing address

4190 Loberg Ave
Duluth, MN 55811-2652
Phone (218) 249-5700

Other practice location 1

213 2nd Ave NE
Rolla, ND 58367-7153
Phone (701) 477-3161

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
R39513OtherNDLICENSE

Electronic endpoints 1

NPPES NPI Registry
TypeEndpointUseAffiliation
Direct Messaging Address him@slk.direct.slhduluth.com

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 19, 2021.

{
    "created_epoch": "1377129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611014400000",
    "number": "1619301975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4190 LOBERG AVE",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558112652",
            "telephone_number": "218-249-5700",
            "fax_number": "218-249-4666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4190 LOBERG AVE",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "55811",
            "telephone_number": "218-249-5700",
            "fax_number": "218-249-4666"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "213 2nd Ave NE",
            "address_purpose": "LOCATION",
            "city": "Rolla",
            "state": "ND",
            "postal_code": "583677153",
            "country_code": "US",
            "telephone_number": "701-477-3161",
            "fax_number": "701-477-5564",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENNING",
        "first_name": "KIMBERLY",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-22",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "6421",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "R39513",
            "state": "ND"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@slk.direct.slhduluth.com",
            "affiliation": "N",
            "address_1": "4190 Loberg Ave",
            "city": "Duluth",
            "state": "MN",
            "country_code": "US",
            "postal_code": "55811",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.