NPIMap

Individual provider Active NPI

Kristina Rae Carlson, RN, MSN, NP-C

  • Family Nurse Practitioner
  • Springfield, MN
National Provider Identifier
1760824874
Registry record updated Aug 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1502 Issued in MN
Practice address
625 N. Jackson Avenue
Springfield, MN 56087
Phone
(877) 412-7575
NPI assigned
Jul 18, 2013
Last updated
Aug 25, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1502 MN Primary

Addresses

Primary practice location

625 N. Jackson Avenue
Springfield, MN 56087

Mailing address

625 N. Jackson Avenue
Springfield, MN 56087
Phone (877) 412-7575

Other identifiers 1

IdentifierTypeStateIssuer
R1748934OtherMNRN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130827000153 MN Practitioner - Nurse Practitioner 2163665969 Reassigns benefits to 1 organization

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
Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians

Practice addresses (Care Compare)

1324 5TH St N
New Ulm, MN 56073-1514
Phone (507) 217-5199

2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (612) 863-4000

625 N Jackson Ave
Springfield, MN 56087-1714
Phone (507) 723-6201

PO Box
Minneapolis, MN 55440-0043

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
1502MNMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System Current Accepting new patients
Allina Health System CurrentSince Mar 15, 2020 Accepting new patients
Allina Health System CurrentSince Mar 15, 2020 Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region Past Accepting new patients

Locations

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

301 2nd St NE
New Prague, MN 56071
Phone (952) 758-4431

625 N Jackson Ave
Springfield, MN 56087
Phone (507) 723-3523

Interoperability endpoints

  • Direct secure messaging: kcarlson270031@excellian.direct.allina.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 27

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

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1374105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598313600000",
    "number": "1760824874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 N. JACKSON AVENUE",
            "city": "SPRINGFIELD",
            "state": "MN",
            "postal_code": "56087",
            "telephone_number": "877-412-7575",
            "fax_number": "507-723-6447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 N. JACKSON AVENUE",
            "city": "SPRINGFIELD",
            "state": "MN",
            "postal_code": "56087",
            "telephone_number": "877-412-7575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "KRISTINA",
        "middle_name": "RAE",
        "name_prefix": "Mrs.",
        "credential": "RN, MSN, NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-18",
        "last_updated": "2020-08-25",
        "certification_date": "2020-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "1502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN",
            "identifier": "R1748934",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MN

Sources for this page

Verify at the official NPI Registry.