Kristin M Dettmer, APRN

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

357 Issued in MN

Practice address

345 North Smith Ave
Childrens Hospitals and Clinics of Minnesota
St Paul, MN 55102

Phone

(651) 220-6914

NPI assigned

Nov 1, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Allina Health System

  • Obstetrics & Gynecology Physician
  • Buffalo, MN
  • NPI 1295272342
  Medicare reassignment NPD
• Childrens Health Care

  • Pediatrics Physician
  • Minneapolis, MN
  • NPI 1932208808
  Medicare reassignment NPD
• Emergency Care Consultants, PA

  • Emergency Medicine Physician
  • Minneapolis, MN
  • NPI 1669422788
  Medicare reassignment NPD
• Allina Health System

  • Family Medicine Physician
  • New Ulm, MN
  • NPI 1619911658
  NPD
• Children'S Health Care

  • Radiology Clinic/Center
  • Minneapolis, MN
  • NPI 1093994030
  NPD
• Ecc Addiction & Toxicology Services LLC

  • Medical Toxicology (Emergency Medicine) Physician
  • Minneapolis, MN
  • NPI 1629532429
  NPD (past)

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1851478895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2910 CENTRE POINTE DR 35-121A",
            "address_2": "CHILDRENS HEALTH CARE",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "55113",
            "telephone_number": "651-855-2327",
            "fax_number": "651-855-2310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 NORTH SMITH AVE",
            "address_2": "CHILDRENS HOSPITALS AND CLINICS OF MINNESOTA",
            "city": "ST PAUL",
            "state": "MN",
            "postal_code": "55102",
            "telephone_number": "651-220-6914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETTMER",
        "first_name": "KRISTIN",
        "middle_name": "M",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MN",
            "license": "357",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "797603800",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tera Marie Detels, LGSW
• Jessica Determan, CPNP
• Megan Deters, MA, LMFT
• Ronald Patrick Detomaso
• Andrew Dettle
• Irene Carolyn Detviler, RN
• Andrea Elizabeth Deuring, LPCC
• Swapna Devanna, MD
• Allisen Deville, LICSW
• Brian John Devoe, DDS

• Pediatric Nurse Practitioner in St Paul, MN
• Providers in St Paul, MN by specialty
• Pediatric Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 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.

Verify at the official NPI Registry.