Active NPI
Tom Kern, PH.D., L.P.
- Psychologist
- Eden Prairie, MN
National Provider Identifier
1689648784
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- LP0289
- Practice address
- 11800 Singletree LN
#203
Eden Prairie, MN 55344-5328 - Phone
- (952) 944-5502
- NPI assigned
- Feb 15, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | LP0289 | MN | |
| Clinical Psychologist | 103TC0700X | LP0289 | MN | |
| Psychologist | 103T00000X | LP0289 | MN | Primary |
Addresses
Primary practice location
11800 Singletree LN
#203
Eden Prairie, MN 55344-5328
Mailing address
9637 Anderson Lakes Pkwy
Ste. #162
Eden Prairie, MN 55344-4155
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 61-70220 | Other | MN | MEDICA AND UBH |
| 123553 | Other | MN | UCARE |
| 279S6KE | Other | MN | BLUE CROSS BLUE SHIELD MN |
| HP30512 | Other | MN | HEALTHPARTNERS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP0289 | MN | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139961600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1689648784",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9637 ANDERSON LAKES PKWY",
"address_2": "STE. #162",
"city": "EDEN PRAIRIE",
"state": "MN",
"postal_code": "553444155"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11800 SINGLETREE LN",
"address_2": "#203",
"city": "EDEN PRAIRIE",
"state": "MN",
"postal_code": "553445328",
"telephone_number": "952-944-5502"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KERN",
"first_name": "TOM",
"credential": "PH.D., L.P.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-15",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "MN",
"license": "LP0289",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MN",
"license": "LP0289",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MN",
"license": "LP0289",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA AND UBH",
"identifier": "61-70220",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UCARE",
"identifier": "123553",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD MN",
"identifier": "279S6KE",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHPARTNERS",
"identifier": "HP30512",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Eden Prairie, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.