Thomas E Kottke, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

24324 Issued in MN

Practice address

640 Jackson Street
MC 11102H
St Paul, MN 55101-2502

Phone

(651) 254-5175

Fax

(651) 254-1603

NPI assigned

Feb 27, 2006

Last updated

May 12, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210550400000",
    "number": "1255307617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 JACKSON ST",
            "address_2": "MAIL STOP 11102H",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551012502",
            "telephone_number": "651-254-5175",
            "fax_number": "651-254-1603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 JACKSON STREET",
            "address_2": "MC 11102H",
            "city": "ST PAUL",
            "state": "MN",
            "postal_code": "551012502",
            "telephone_number": "651-254-5175",
            "fax_number": "651-254-1603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTTKE",
        "first_name": "THOMAS",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-27",
        "last_updated": "2008-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MN",
            "license": "24324",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WI",
            "license": "47187-0Z0",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "363773500",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Taylor Korynta, LICSW
• Therese Anne Kosch, RPT
• Kevin Kosel, DPT
• Gwendolyn Martinique Kosevich, MSN
• Sarah Jane Kottke, MD
• Jocelyne Koudou
• Teresa F Kovarik, MD
• Jonathon William Koverman, MPT
• Alexander G Kovic
• Wendy Jo Kovich

• Cardiovascular Disease Physician in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Cardiovascular Disease Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 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.