1356430284 NPI number — ROBERT R KEMPAINEN MD

Table of content: ROBERT R KEMPAINEN MD (NPI 1356430284)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356430284 NPI number — ROBERT R KEMPAINEN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KEMPAINEN
Provider First Name:
ROBERT
Provider Middle Name:
R
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1356430284
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/21/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
701 PARK AVE # G5
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MINNEAPOLIS
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55415-1623
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
701 PARK AVE
Provider Second Line Business Practice Location Address:
S-1
Provider Business Practice Location Address City Name:
MINNEAPOLIS
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55415-1623
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
612-873-9700
Provider Business Practice Location Address Fax Number:
612-904-4675
Provider Enumeration Date:
10/11/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RP1001X , with the licence number:  45010 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1677703 . This is a "ARAZ" identifier . This identifiers is of the category "OTHER".
  • Identifier: HP40336 . This is a "HEALTH PARTNERS" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 48-00006 . This is a "MEDICA-PRIMARY" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 521492 . This is a "FAIRVIEW" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 091079100 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0554048 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1031655 . This is a "PREFERRED ONE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 142141 . This is a "UCARE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 48-00264 . This is a "MEDICA-CHOICE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".




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