Individual provider Active NPI

Emily Jean Kidd, M.ED., LAT, ATC

  • Athletic Trainer
  • Saint Paul, MN
National Provider Identifier
1235576018
Registry record updated May 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
2675 Issued in NC
Practice address
2300 Doswell Ave
Saint Paul, MN 55108-1636
Phone
(651) 262-3227
NPI assigned
Jun 3, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 2675 NC Primary

Addresses

Primary practice location

2300 Doswell Ave
Saint Paul, MN 55108-1636

Mailing address

2300 Doswell Ave
Saint Paul, MN 55108-1636

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
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
2675NCMDCounseling Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1370217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494374400000",
    "number": "1235576018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 DOSWELL AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551081636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 DOSWELL AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551081636",
            "telephone_number": "651-262-3227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIDD",
        "first_name": "EMILY",
        "middle_name": "JEAN",
        "credential": "M.ED., LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-03",
        "last_updated": "2017-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NC",
            "license": "2675",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 May 10, 2017; 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.