Active NPI
Dido G Kotile
- Nursing Home Administrator
- Woodbury, MN
National Provider Identifier
1003500430
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nursing Home Administrator
- Practice address
- 3226 Hamlet Dr
Woodbury, MN 55125-2709 - Phone
- (651) 233-3857
- NPI assigned
- Jun 7, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nursing Home Administrator | 376G00000X | MN | Primary |
Addresses
Primary practice location
3226 Hamlet Dr
Woodbury, MN 55125-2709
Mailing address
3226 Hamlet Dr
Woodbury, MN 55125-2709
Phone (651) 233-3857
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1686096000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686096000000",
"number": "1003500430",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3226 HAMLET DR",
"city": "WOODBURY",
"state": "MN",
"postal_code": "551252709",
"telephone_number": "651-233-3857"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3226 HAMLET DR",
"city": "WOODBURY",
"state": "MN",
"postal_code": "551252709",
"telephone_number": "651-233-3857"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOTILE",
"first_name": "DIDO",
"middle_name": "G",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-06-07",
"last_updated": "2023-06-07",
"certification_date": "2023-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "376G00000X",
"taxonomy_group": "",
"desc": "Nursing Home Administrator",
"state": "MN",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodbury, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.