Individual provider Active NPI

Joan E Kreider, MD

  • Obstetrics & Gynecology Physician
  • Saint Paul, MN
National Provider Identifier
1225007180
Registry record updated Apr 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
27157 Issued in MN
Practice address
2635 University Ave Suite 160
Mail Stop 13901B
Saint Paul, MN 55114-1271
Phone
(651) 254-3500
Fax
(651) 254-3699
NPI assigned
Mar 14, 2006
Last updated
Apr 30, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 27157 MN Primary

Addresses

Primary practice location

2635 University Ave Suite 160
Mail Stop 13901B
Saint Paul, MN 55114-1271

Mailing address

2635 University Ave W
Saint Paul, MN 55114-1270
Phone (651) 254-3500

Other identifiers 1

IdentifierTypeStateIssuer
731867700MedicaidMN

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
27157MNMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209513600000",
    "number": "1225007180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2635 UNIVERSITY AVE W",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551141270",
            "telephone_number": "651-254-3500",
            "fax_number": "651-254-3699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2635 UNIVERSITY AVE SUITE 160",
            "address_2": "MAIL STOP 13901B",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551141271",
            "telephone_number": "651-254-3500",
            "fax_number": "651-254-3699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KREIDER",
        "first_name": "JOAN",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-14",
        "last_updated": "2008-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MN",
            "license": "27157",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "731867700",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2008; 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.