NPIMap

Individual provider Active NPI

Kimberly Sebo, CNP

  • Women's Health Nurse Practitioner
  • Coon Rapids, MN
National Provider Identifier
1952061848
Registry record updated May 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
7085 Issued in MN
Practice address
3960 Coon Rapids Blvd NW
Ste 200
Coon Rapids, MN 55433-2589
Phone
(763) 236-9236
Fax
(763) 236-9250
NPI assigned
Dec 20, 2021
Last updated
May 31, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 7085 MN Primary

Addresses

Primary practice location

3960 Coon Rapids Blvd NW
Ste 200
Coon Rapids, MN 55433-2589

Mailing address

2925 Chicago Avenue
Minneapolis, MN 55407-1321
Phone (612) 262-5000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kgreening101689@excellian.direct.allina.com Direct

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
I20220928000382 MN Practitioner - Nurse Practitioner 7810373974 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Georgetown University School of Medicine, 2019
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)

3960 Coon Rapids Blvd NW
Suite 200
Coon Rapids, MN 55433-2589
Phone (763) 236-9236

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.6 of 100Reported as group
Quality
72.5
Promoting interoperability
100
Improvement activities
40
Cost
77.07

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System Current Accepting new patients
Planned Parenthood Minnesota, North Dakota, South Dakota CurrentSince May 12, 2022 Accepting new patients
Allina Health System CurrentSince Jun 20, 2023 Accepting new patients
Allina Health System CurrentSince Jun 20, 2023 Accepting new patients
Allina Health System Past Accepting new patients

Locations

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

3960 Coon Rapids Blvd NW
Ste 200
Coon Rapids, MN 55433
Phone (763) 236-9236

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

2925 Chicago Ave
Minneapolis, MN 55407
Phone (612) 262-4813

3960 Coon Rapids Blvd NW
Ste 2
Minneapolis, MN 55433

671 Vandalia St
Saint Paul, MN 55114
Phone (651) 696-5674

4194 Lexington Ave N
Shoreview, MN 55126
Phone (651) 483-5461

1795 Radio Dr
Ste D
Woodbury, MN 55125
Phone (651) 696-5550

Interoperability endpoints

  • Direct secure messaging: kgreening101689@excellian.direct.allina.com

Organizations & group practices 5

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 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1639958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685491200000",
    "number": "1952061848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 CHICAGO AVENUE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071321",
            "telephone_number": "612-262-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3960 COON RAPIDS BLVD NW",
            "address_2": "STE 200",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554332589",
            "telephone_number": "763-236-9236",
            "fax_number": "763-236-9250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEBO",
        "first_name": "KIMBERLY",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-20",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MN",
            "license": "7085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kgreening101689@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "3960 Coon Rapids Blvd NW",
            "address_2": "STE 200",
            "city": "Coon Rapids",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554332589",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Coon Rapids, MN

Sources for this page

Verify at the official NPI Registry.