Individual provider Active NPI

Kimberly Northwick

  • Family Nurse Practitioner
  • Saint Paul, MN
National Provider Identifier
1871921049
Registry record updated Oct 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2288901 Issued in MN
Practice address
640 Jackson St
Saint Paul, MN 55101
Phone
(651) 254-4887
NPI assigned
Oct 24, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5531-33 WI
Family Nurse Practitioner 363LF0000X 2288901 MN Primary

Addresses

Primary practice location

640 Jackson St
Saint Paul, MN 55101

Mailing address

8170 33Rd Ave S # Ms 21110Q
Minneapolis, MN 55425-4516

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, MN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20131120000497 WI Practitioner - Nurse Practitioner 9234365339 Reassigns benefits to 2 organizations
I20150814013601 MN Practitioner - Nurse Practitioner 9234365339 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
Group Health IncGroup PAC ID 1759293954, 1,627 clinicians

Practice addresses (Care Compare)

14701 Victor Hugo Blvd N
Hugo, MN 55038-4561
Phone (651) 767-1900

15350 English Ave
Apple Valley, MN 55124-6252
Phone (952) 431-8500

411 Stageline Rd
Suite 200
Hudson, WI 54016-7848
Phone (715) 531-6700

640 Jackson St
Saint Paul, MN 55101-2502
Phone (651) 221-3456

8325 Seasons Pkwy
Woodbury, MN 55125-4402
Phone (651) 702-5868

8450 Seasons Pkwy
Woodbury, MN 55125-4402
Phone (651) 702-5300

8600 Nicollet Ave
Bloomington, MN 55420-2824
Phone (952) 884-1148

Hospital & facility affiliations

  • Regions Hospital Hospital, Saint Paul, MN, CCN 240106
  • Hudson Hospital Hospital, Hudson, WI, CCN 521335
  • Lakeview Memorial Hospital Hospital, Stillwater, MN, CCN 240066
  • Westfields Hospital and Clinic Hospital, New Richmond, WI, CCN 521345

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5531-33WIMDNurse Practitioner
2288901MNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Group Health, Inc. CurrentSince Jan 16, 2017 Accepting new patients
Westfields Hospital, Inc. Nurse Practitioner CurrentSince Feb 1, 2019 Accepting new patients
Group Health, Inc. CurrentSince Sep 1, 2015 Accepting new patients
Group Health, Inc. CurrentSince Sep 1, 2015 Accepting new patients
Westfields Hospital, Inc. Current Accepting new patients
Westfields Hospital, Inc CurrentSince Feb 1, 2019 Accepting new patients

Locations

8170 33rd Ave S
Minneapolis, MN 55425
Phone (952) 883-5463

2220 Riverside Ave
Minneapolis, MN 55454
Phone (612) 371-1600

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375

640 Jackson St
Saint Paul, MN 55101
Phone (651) 221-2164

927 Churchill St W
Stillwater, MN 55082
Phone (651) 430-4529

405 Stageline Rd
Hudson, WI 54016
Phone (715) 531-6000

411 Stageline Rd
Ste 200
Hudson, WI 54016
Phone (715) 531-6700

411 Stageline Rd
#200
Hudson, WI 54016
Phone (715) 531-6700

535 Hospital Rd
New Richmond, WI 54017
Phone (651) 292-2013

744 E Louisiana St
St Croix Fls, WI 54024
Phone (651) 772-6251

Organizations & group practices 6

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.

Hospital & facility affiliations 12

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

NPI Registry JSON

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

{
    "created_epoch": "1382572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666051200000",
    "number": "1871921049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S # MS 21110Q",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554254516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 JACKSON ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "55101",
            "telephone_number": "651-254-4887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORTHWICK",
        "first_name": "KIMBERLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-24",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "5531-33",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "2288901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.