Kailey Anderson

Primary specialty

Case Management Registered NurseTaxonomy code 163WC0400X

License

2507658 Issued in MN

Practice address

12567 5TH Ave N Ste 100
Zimmerman, MN 55398-8453

Phone

(763) 856-9955

NPI assigned

Apr 18, 2024

Last updated

Apr 18, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Kailey Johnson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• North Country Home Care II, Inc

  • Home Health Agency
  • Zimmerman, MN
  • NPI 1174723746
  NPD (past)

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

{
    "created_epoch": "1713398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713398400000",
    "number": "1679328223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9519 RIVER FOREST DR",
            "city": "MONTICELLO",
            "state": "MN",
            "postal_code": "553623336",
            "telephone_number": "763-732-8917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12567 5TH AVE N STE 100",
            "city": "ZIMMERMAN",
            "state": "MN",
            "postal_code": "553988453",
            "telephone_number": "763-856-9955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "KAILEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-18",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "2507658",
            "primary": false
        },
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "MN",
            "license": "2507658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAILEY",
            "last_name": "JOHNSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Advocate Urgent Care PLLC
• Advocate Wound Care LLC
• Aegis Group Practice LLC
• Paul C Allegra, MD
• Holly Altenhofen
• Valerie Ann Anderson, R.N.
• Ascent Wellness, LLC
• Theresa A Beardsley, REGISTERED NURSE
• Stephanie Ardella Bebeau
• Belde Family Chiropractic P.C.

• Case Management Registered Nurse in Zimmerman, MN
• Providers in Zimmerman, MN by specialty
• Case Management Registered Nurse in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2024; 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.