NPIMap

Individual provider Active NPI

Kevin C Nelson, MD

  • Family Medicine Physician
  • Richfield, MN
National Provider Identifier
1891765202
Registry record updated Jan 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34912 Issued in MN
Practice address
6440 Nicollet Ave
Richfield, MN 55423-1697
Phone
(612) 861-1622
Fax
(612) 861-2307
NPI assigned
Jan 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 34912 MN Primary

Addresses

Primary practice location

6440 Nicollet Ave
Richfield, MN 55423-1697

Mailing address

6440 Nicollet Ave
Richfield, MN 55423-1613
Phone (612) 861-1622

Other identifiers 1

IdentifierTypeStateIssuer
820762300MedicaidMN

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
I20100119000771 MN Practitioner - Family Practice 9830171875 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Rush Medical College of Rush University, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Richfield Medical Group LTDGroup PAC ID 9032154497, 7 clinicians

Practice addresses (Care Compare)

44 W 66TH St
Richfield, MN 55423-2316

Hospital & facility affiliations

  • Accentcare Fairview Home Health - West, LLC Home health agency, Saint Paul, MN, CCN 247078
  • Gentiva Hospice, Edina, MN, CCN 241611
  • M Health Fairview Southdale Hospital Hospital, Edina, MN, CCN 240078
  • M Health Fairview University of MN Medical Center Hospital, Minneapolis, MN, CCN 240080
  • M Health Fairview Ridges Hospital Hospital, Burnsville, MN, CCN 240207

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Richfield Medical Group LTD Family Medicine CurrentSince Jul 1, 1991 Accepting new patients
Fairview Health Services PastSince Apr 1, 2011 Accepting new patients
Fairview Pharmacy Services LLC PastSince Jan 21, 2024 Accepting new patients

Locations

6440 Nicollet Ave
Richfield, MN 55423
Phone (612) 210-7494

44 W 66th St
Unit 10
Richfield, MN 55423
Phone (612) 861-1622

Interoperability endpoints

  • Direct secure messaging: knelson3444@fairview.direct-ci.com

Organizations & group practices 3

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 9

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": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705536000000",
    "number": "1891765202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6440 NICOLLET AVE",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554231613",
            "telephone_number": "612-861-1622",
            "fax_number": "612-861-2307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6440 NICOLLET AVE",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554231697",
            "telephone_number": "612-861-1622",
            "fax_number": "612-861-2307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "KEVIN",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-26",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "34912",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "820762300",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richfield, MN

Sources for this page

Verify at the official NPI Registry.