Kennita Rashediah Solberg, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

79816 Issued in MN

Practice address

5700 Bottineau Blvd Ste 100
Crystal, MN 55429-3184

Phone

(763) 504-6500

Fax

(763) 537-1972

NPI assigned

Apr 25, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kennita Kennedy Former name

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Medical Technician

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ksolberg892669@direct.centracare.com

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.

• Northwest Family Physicians PA

  • Family Medicine Physician
  • Crystal, MN
  • NPI 1548366867
  Medicare reassignment NPD
• Lifecare Medical Center

  • Critical Access Hospital
  • Roseau, MN
  • NPI 1609861095
  Medicare reassignment

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

{
    "created_epoch": "1682380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785283200000",
    "number": "1376231746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 BOTTINEAU BLVD STE 100",
            "city": "CRYSTAL",
            "state": "MN",
            "postal_code": "554293184",
            "telephone_number": "763-504-6500",
            "fax_number": "763-537-1972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 BOTTINEAU BLVD STE 100",
            "city": "CRYSTAL",
            "state": "MN",
            "postal_code": "554293184",
            "telephone_number": "763-504-6500",
            "fax_number": "763-537-1972"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2426 W Broadway Ave",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554111735",
            "country_code": "US",
            "telephone_number": "612-302-8200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOLBERG",
        "first_name": "KENNITA",
        "middle_name": "RASHEDIAH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-25",
        "last_updated": "2026-07-29",
        "certification_date": "2026-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "79816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KENNITA",
            "last_name": "KENNEDY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Joshua Oneal Simmons
• Shannon Renee Smaaladen
• David C Smiley, MD
• Heather Smith
• Gretchen Soberay Betts, DO
• Sonus-USA, Inc.
• Jessica Stalberger, CPHT
• State of MN Receivership - Terrace Crystal
• Michelle Steele
• Timothy Todd Stenzel, MD, PHD

• Family Medicine Physician in Crystal, MN
• Providers in Crystal, MN by specialty
• Family Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.