Active NPI
Kyle M Halvorson, OD
- Ophthalmology Physician
- Red Wing, MN
National Provider Identifier
1295700268
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 2037
- Practice address
- 701 Hewitt Blvd
Red Wing, MN 55066-2848 - Phone
- (651) 267-5000
- NPI assigned
- Feb 22, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 2037 | MN | Primary |
Addresses
Primary practice location
701 Hewitt Blvd
Red Wing, MN 55066-2848
Mailing address
701 Hewitt Blvd
Red Wing, MN 55066-2848
Phone (651) 267-5000
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
Interoperability endpoints
- khalvorson88351@ehrdirect.mayoclinicmsg.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140566400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1672099200000",
"number": "1295700268",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "701 HEWITT BLVD",
"city": "RED WING",
"state": "MN",
"postal_code": "550662848",
"telephone_number": "651-267-5000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "701 HEWITT BLVD",
"city": "RED WING",
"state": "MN",
"postal_code": "550662848",
"telephone_number": "651-267-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALVORSON",
"first_name": "KYLE",
"middle_name": "M",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-22",
"last_updated": "2022-12-27",
"certification_date": "2022-12-27",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "MN",
"license": "2037",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Red Wing, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.