Individual provider Active NPI

Kristen Ann Nordahl, CNM

  • Advanced Practice Midwife
  • Woodbury, MN
National Provider Identifier
1972374379
Registry record updated Jan 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
Practice address
1687 Woodlane Dr
Woodbury, MN 55125-3045
Phone
(651) 600-3035
NPI assigned
Jan 15, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X MN Primary

Addresses

Primary practice location

1687 Woodlane Dr
Woodbury, MN 55125-3045

Mailing address

6936 Sherwood Rd
Woodbury, MN 55125-2484
Phone (715) 896-1989

Other practice location 1

2603 White Bear Ave N
Maplewood, MN 55109-5110
Phone (651) 600-3035

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240516003418 MN Practitioner - Certified Nurse Midwife (CNM) 9436590767 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Minnesota Womens Care PAGroup PAC ID 9638329394, 44 clinicians

Practice addresses (Care Compare)

2603 White Bear Ave N
Maplewood, MN 55109-5110
Phone (651) 600-3035

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
573MNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Healthcare for Women, PA CurrentSince Mar 19, 2024 Accepting new patients
Minnesota Women'S Care, P.a. CurrentSince Mar 19, 2024 Accepting new patients
Healtheast St. John'S Hospital Past Accepting new patients
Healtheast Woodwinds Hospital Past Accepting new patients

Locations

15000 Garrett Ave
Apple Valley, MN 55124

2603 White Bear Ave N
Saint Paul, MN 55109
Phone (651) 209-8125

1687 Woodlane Dr
Woodbury, MN 55125
Phone (651) 209-6685

1687 Woodlane Dr
Ste 101
Woodbury, MN 55125
Phone (651) 209-6263

Interoperability endpoints

  • Direct secure messaging: kristen.nordahl@mwc.eclinicaldirectplus.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/FAHCDA

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1705276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705276800000",
    "number": "1972374379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6936 SHERWOOD RD",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551252484",
            "telephone_number": "715-896-1989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1687 WOODLANE DR",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551253045",
            "telephone_number": "651-600-3035"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2603 White Bear Ave N",
            "address_purpose": "LOCATION",
            "city": "Maplewood",
            "state": "MN",
            "postal_code": "551095110",
            "country_code": "US",
            "telephone_number": "651-600-3035",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NORDAHL",
        "first_name": "KRISTEN",
        "middle_name": "ANN",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-15",
        "last_updated": "2024-01-15",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, MN

Sources for this page

Verify at the official NPI Registry.