Active NPI
Kaitlin M Keeney
- Family Nurse Practitioner
- Edina, MN
National Provider Identifier
1912512096
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 6984
- Practice address
- 6905 York Ave S
Edina, MN 55435-2517 - Phone
- (866) 389-2727
- NPI assigned
- Sep 15, 2020
- Last updated
- Aug 1, 2022
- 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 | 6984 | MN | Primary |
Addresses
Primary practice location
6905 York Ave S
Edina, MN 55435-2517
Mailing address
865 Mendakota CT
Mendota Heights, MN 55120-1336
Phone (651) 270-1370
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 |
|---|---|---|---|
| 6984 | MN | MD | Chiropractor |
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1600128000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659312000000",
"number": "1912512096",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "865 MENDAKOTA CT",
"city": "MENDOTA HEIGHTS",
"state": "MN",
"postal_code": "551201336",
"telephone_number": "651-270-1370"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6905 YORK AVE S",
"city": "EDINA",
"state": "MN",
"postal_code": "554352517",
"telephone_number": "866-389-2727"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEENEY",
"first_name": "KAITLIN",
"middle_name": "M",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-09-15",
"last_updated": "2022-08-01",
"certification_date": "2022-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MN",
"license": "6984",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Edina, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.