Provider Demographics
NPI:1912271180
Name:KARI PRESCOTT DPM PA
Entity Type:Organization
Organization Name:KARI PRESCOTT DPM PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:KARI
Authorized Official - Middle Name:E
Authorized Official - Last Name:PRESCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:612-338-4731
Mailing Address - Street 1:825 NICOLLET MALL STE 441
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55402-2611
Mailing Address - Country:US
Mailing Address - Phone:612-338-4731
Mailing Address - Fax:612-886-1729
Practice Address - Street 1:825 NICOLLET MALL STE 441
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55402-2611
Practice Address - Country:US
Practice Address - Phone:612-338-4731
Practice Address - Fax:612-886-1729
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-05
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN683213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
6144443OtherSTATE TAX ID
MN4811940001Medicare NSC