Active NPI
Kathryn Popp, CPNP
- Nurse Practitioner
- Maple Grove, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 3056
- Practice address
- 9555 Upland LN N
Maple Grove, MN 55369-4485 - Phone
- (952) 977-0275
- NPI assigned
- Apr 2, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | R-137276-6 | MN | |
| Nurse Practitioner | 363L00000X | 3056 | MN | Primary |
Addresses
Primary practice location
9555 Upland LN N
Maple Grove, MN 55369-4485
Mailing address
8170 33Rd Ave S # Ms 21110Q
Bloomington, MN 55425-4516
Other practice location 1
2525 Chicago Ave
Minneapolis, MN 55404-4518
Phone (612) 813-7888
Medicare participation
Medicare enrollment files- 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: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Pediatric Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R-137276-6 | MN | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Park Nicollet Clinic | Current | Accepting new patients | |
| Emergency Care Consultants, PA | Current | Accepting new patients | |
| Park Nicollet Clinic | Current | Accepting new patients | |
| Park Nicollet Clinic | Current | Accepting new patients |
Locations
9555 Upland Ln N
Maple Grove, MN 55369
Phone (952) 993-1440
8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375
800 E 28th St
Minneapolis, MN 55407
Phone (612) 863-3547
5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400
2855 Campus Dr
Plymouth, MN 55441
Phone (763) 577-7000
Organizations & group practices 4
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.
-
- Emergency Medicine Physician
- Minneapolis, MN
- NPI 1669422788
-
- Family Medicine Physician
- St Louis Park, MN
- NPI 1780621904
-
- Family Medicine Physician
- St Louis Park, MN
- NPI 1063897593
-
- Family Medicine Physician
- Brooklyn Park, MN
- NPI 1447668678
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1396396800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1708646400000",
"number": "1710305271",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8170 33RD AVE S # MS 21110Q",
"city": "BLOOMINGTON",
"state": "MN",
"postal_code": "554254516"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9555 UPLAND LN N",
"city": "MAPLE GROVE",
"state": "MN",
"postal_code": "553694485",
"telephone_number": "952-977-0275"
}
],
"practiceLocations": [
{
"address_1": "2525 Chicago Ave",
"address_purpose": "LOCATION",
"city": "Minneapolis",
"state": "MN",
"postal_code": "554044518",
"country_code": "US",
"telephone_number": "612-813-7888",
"fax_number": "612-813-7199",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "POPP",
"first_name": "KATHRYN",
"credential": "CPNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-04-02",
"last_updated": "2024-02-23",
"certification_date": "2024-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "MN",
"license": "R-137276-6",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MN",
"license": "3056",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Maple Grove, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2024; 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.