Individual provider Active NPI

Tamara Lynn Whyte Kasmarik, CNP

  • Pediatric Nurse Practitioner
  • Minnetonka, MN
National Provider Identifier
1952373102
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
R0999234 Issued in MN
Practice address
17705 Hutchins Dr Ste 101
Minnetonka, MN 55345-4102
Phone
(952) 401-8300
NPI assigned
Feb 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X R0999234 MN Primary

Addresses

Primary practice location

17705 Hutchins Dr Ste 101
Minnetonka, MN 55345-4102

Mailing address

17705 Hutchins Dr Ste 101
Minnetonka, MN 55345-4102
Phone (952) 401-8300

Other identifiers 3

IdentifierTypeStateIssuer
046G4KAOtherMNBCBS
CP9041014218OtherMNPREFERRED ONE
1202588OtherMNMEDICA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R0999234MNMDPediatric Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1952373102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17705 HUTCHINS DR STE 101",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553454102",
            "telephone_number": "952-401-8300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17705 HUTCHINS DR STE 101",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553454102",
            "telephone_number": "952-401-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHYTE KASMARIK",
        "first_name": "TAMARA",
        "middle_name": "LYNN",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-02",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MN",
            "license": "R0999234",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "046G4KA",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "CP9041014218",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "1202588",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minnetonka, MN

Sources for this page

Verify at the official NPI Registry.