DR. KAREN NICOLE CHINNOCK (PH.D, LP) – Psychologist, NPI 1164065868

DR. KAREN NICOLE CHINNOCK (PH.D, LP) is a healthcare provider. based in Eagan, Minnesota. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PH.D, LP. They hold a License No. LP6468 (MN). The NPI Number for DR. KAREN NICOLE CHINNOCK (PH.D, LP) is 1164065868

Main info

Female
8 Years Of Experience
Accepts Medicare Assignment
Name
DR. KAREN NICOLE CHINNOCK (PH.D, LP)
NPI
1164065868
Phone
(651) 348-8851
Address
930 BLUE GENTIAN RD
Enumeration Date
25 October 2019
Last Update Date
25 October 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9524434600
Graduation Year
2018 (8 years ago)
PAC ID
3274966502
Group Practice PAC ID
7810282845
Professional Enrollment ID
I20191127001149
Address ID
MN553867720VI1772XLNXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:6State licenses:1Digital endpointsOther names

1,110 CLINICAL PSYCHOLOGIST in MN

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Provider Addresses for DR. KAREN NICOLE CHINNOCK (PH.D, LP)

  • 930, Blue Gentian Road, Eagan, Dakota County, Minnesota, 55121, United States

    EAGAN, MN 551211674

    Phone: (651) 348-8851

    Type: Location

  • 1957, Schoolmaster Drive, Chaska, Carver County, Minnesota, 55318, United States

    CHASKA, MN 553184554

    Phone: (732) 979-3767

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2019-11-27

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20191127001149IClinical PsychologistMNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55121)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7810282845View full group profile
NameSpecialtyState
Clinical PsychologistMN
Clinical Social WorkerMN
Mental Health CounselorMN
Mental Health CounselorMN
Marriage And Family TherapistMN
Mental Health CounselorMN
Marriage And Family TherapistMN
Clinical Social WorkerMN
Clinical Social WorkerMN
Clinical Social WorkerMN

Reviews

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Frequently asked questions

What unique ID ties claims to DR. KAREN NICOLE CHINNOCK (PH.D, LP)?
NPI 1164065868 is assigned to DR. KAREN NICOLE CHINNOCK (PH.D, LP) under the national enumeration system.
Does this profile mean DR. KAREN NICOLE CHINNOCK (PH.D, LP) is currently active?
Yes — DR. KAREN NICOLE CHINNOCK (PH.D, LP) appears active in the national provider directory.
What field does DR. KAREN NICOLE CHINNOCK (PH.D, LP) work in?
You can think of DR. KAREN NICOLE CHINNOCK (PH.D, LP) as practicing within Psychologist. Clinical services aligned with this taxonomy classification.
Does DR. KAREN NICOLE CHINNOCK (PH.D, LP) practice in Minnesota?
You will see Eagan, Minnesota on file for DR. KAREN NICOLE CHINNOCK (PH.D, LP) alongside any extra practice locations.
Is DR. KAREN NICOLE CHINNOCK (PH.D, LP) a real provider?
This page reflects official NPPES data for NPI 1164065868. Always confirm identity and privileges with the practice and licensing boards.

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