Individual provider Active NPI

Yvette A Kidman, MA, LMFT

  • Marriage & Family Therapist
  • Rochester, MN
National Provider Identifier
1003284621
Registry record updated Apr 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
300 3Rd Ave SE Ste 402
Rochester, MN 55904-4613
Phone
(507) 218-8973
Fax
(507) 206-0450
NPI assigned
Sep 14, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X Primary

Addresses

Primary practice location

300 3Rd Ave SE Ste 402
Rochester, MN 55904-4613

Mailing address

300 3Rd Ave SE Ste 402
Rochester, MN 55904-4613
Phone (507) 218-8973

Other practice location 1

1530 Greenview Dr SW Ste 115
Rochester, MN 55902-1080
Phone (507) 259-5210

Other practice location 2

1530 Greenview Dr SW Ste 115
Rochester, MN 55902-1080
Phone (507) 259-5210

Other identifiers 1

IdentifierTypeStateIssuer
1003284621MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 26, 2026 through Jan 26, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Ed Patton LLC. Marriage & Family Therapist PastSince Jun 23, 2025 Accepting new patients

Organizations & group practices 1

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": "1442188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713657600000",
    "number": "1003284621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 3RD AVE SE STE 402",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559044613",
            "telephone_number": "507-218-8973",
            "fax_number": "507-206-0450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 3RD AVE SE STE 402",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559044613",
            "telephone_number": "507-218-8973",
            "fax_number": "507-206-0450"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1530 Greenview Dr SW Ste 115",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "MN",
            "postal_code": "559021080",
            "country_code": "US",
            "telephone_number": "507-259-5210",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1530 Greenview Dr SW Ste 115",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "MN",
            "postal_code": "559021080",
            "country_code": "US",
            "telephone_number": "507-259-5210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIDMAN",
        "first_name": "YVETTE",
        "middle_name": "A",
        "credential": "MA, LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-14",
        "last_updated": "2024-04-21",
        "certification_date": "2024-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003284621",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, MN

Sources for this page

Verify at the official NPI Registry.