Individual provider Active NPI

Kelly L. Rood, M.D.

  • Pediatric Cardiology Physician
  • Minneapolis, MN
National Provider Identifier
1013179407
Registry record updated Apr 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
232727 Issued in MA
Practice address
2530 Chicago Ave
Ste 500
Minneapolis, MN 55404-4291
Phone
(612) 813-8800
Fax
(612) 813-8825
NPI assigned
Jun 27, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X 232727 MA Primary

Addresses

Primary practice location

2530 Chicago Ave
Ste 500
Minneapolis, MN 55404-4291

Mailing address

2530 Chicago Ave
Ste 500
Minneapolis, MN 55404-4291
Phone (612) 813-8800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111114000869 MN Practitioner - Critical Care (Intensivists)Practitioner - Cardiovascular Disease (Cardiology) 1658545322 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
232727MAMDPediatric Cardiology Physician

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": "1214524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334793600000",
    "number": "1013179407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2530 CHICAGO AVE",
            "address_2": "STE 500",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554044291",
            "telephone_number": "612-813-8800",
            "fax_number": "612-813-8825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2530 CHICAGO AVE",
            "address_2": "STE 500",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554044291",
            "telephone_number": "612-813-8800",
            "fax_number": "612-813-8825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROOD",
        "first_name": "KELLY",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-27",
        "last_updated": "2012-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "MA",
            "license": "232727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.