Active NPI
Jennifer Kay Kane
- Family Nurse Practitioner
- Eagan, MN
National Provider Identifier
1730761255
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 8265
- Practice address
- 4241 Johnny Cake Ridge Rd
Eagan, MN 55122-2235 - Phone
- (651) 688-7041
- NPI assigned
- Apr 23, 2021
- Last updated
- Oct 21, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 8265 | MN | Primary |
Addresses
Primary practice location
4241 Johnny Cake Ridge Rd
Eagan, MN 55122-2235
Mailing address
4241 Johnny Cake Ridge Rd
Eagan, MN 55122-2235
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 363LF0000X | Medicaid | MN |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | www.cvs.com | Direct | |
| CONNECT URL | www.cvs.com | Direct |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8265 | MN | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1619136000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1634774400000",
"number": "1730761255",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4241 JOHNNY CAKE RIDGE RD",
"city": "EAGAN",
"state": "MN",
"postal_code": "551222235"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4241 JOHNNY CAKE RIDGE RD",
"city": "EAGAN",
"state": "MN",
"postal_code": "551222235",
"telephone_number": "651-688-7041"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KANE",
"first_name": "JENNIFER",
"middle_name": "KAY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-04-23",
"last_updated": "2021-10-21",
"certification_date": "2021-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MN",
"license": "8265",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "363LF0000X",
"state": "MN"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "www.cvs.com",
"affiliation": "N",
"endpointDescription": "unknown",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "4241 Johnny Cake Ridge Rd",
"city": "Eagan",
"state": "MN",
"country_code": "US",
"postal_code": "551222235",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "www.cvs.com",
"affiliation": "N",
"endpointDescription": "unknown",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "4241 Johnny Cake Ridge Rd",
"city": "Eagan",
"state": "MN",
"country_code": "US",
"postal_code": "551222235",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Eagan, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.