Individual provider Active NPI

Amanda Kohlmeier, M.D.

  • Reproductive Endocrinology Physician
  • Edina, MN
National Provider Identifier
1114289790
Registry record updated Dec 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Reproductive Endocrinology PhysicianTaxonomy code 207VE0102X
License
000000 Issued in MN
Practice address
6565 France Ave S Ste 400
Edina, MN 55435-2137
Phone
(952) 225-1630
Fax
(952) 225-1609
NPI assigned
Jun 11, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Reproductive Endocrinology Physician 207VE0102X 000000 MN Primary

Addresses

Primary practice location

6565 France Ave S Ste 400
Edina, MN 55435-2137

Mailing address

6565 France Ave S Ste 400
Edina, MN 55435-2137
Phone (952) 225-1630

Other practice location 1

5333 McAuley Dr
Suite 2110
Ypsilanti, MI 48197-1014
Phone (734) 712-3967

Other identifiers 1

IdentifierTypeStateIssuer
9034781OtherABOG CERTIFICATION ID NUMBER

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
000000MNMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
CCRM Minneapolis, PC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: amanda.kohlmeier.davies.1@17469.direct.athenahealth.com

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": "1339372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609200000000",
    "number": "1114289790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6565 FRANCE AVE S STE 400",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352137",
            "telephone_number": "952-225-1630",
            "fax_number": "952-225-1609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6565 FRANCE AVE S STE 400",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352137",
            "telephone_number": "952-225-1630",
            "fax_number": "952-225-1609"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5333 McAuley Dr",
            "address_2": "Suite 2110",
            "address_purpose": "LOCATION",
            "city": "Ypsilanti",
            "state": "MI",
            "postal_code": "481971014",
            "country_code": "US",
            "telephone_number": "734-712-3967",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOHLMEIER",
        "first_name": "AMANDA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-11",
        "last_updated": "2020-12-29",
        "certification_date": "2020-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VE0102X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": "MN",
            "license": "000000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ABOG CERTIFICATION ID NUMBER",
            "identifier": "9034781",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.