Kamal Mohamed Kedir

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

1865 Old Hudson Rd # B2
Saint Paul, MN 55119-4308

Phone

(612) 735-6743

NPI assigned

Jun 13, 2024

Last updated

Jun 13, 2024By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Serenity Ridge Care Corporation

  • Community/Behavioral Health Agency
  • Portland, OR
  • NPI 1750212072
  NPD Authorized official
• Southview Autism Services LLC

  • Developmental Disabilities Clinic/Center
  • Eagan, MN
  • NPI 1144083155
  NPD

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

{
    "created_epoch": "1718236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1376386805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1865 OLD HUDSON RD # B2",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551194308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1865 OLD HUDSON RD # B2",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551194308",
            "telephone_number": "612-735-6743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEDIR",
        "first_name": "KAMAL",
        "middle_name": "MOHAMED",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-13",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samuel Kebede, MD
• Tsigereda Kebede, OTR/L
• Lydia Nahbila Kebila, CNP
• Meysam A Kebriaei, MD
• Christina Kedaj
• Kedzie Podiatry PLLC
• Amirthini Theresa Keefe, LICSW
• Meghan Elizabeth Keegan
• Suzanne B Keel, MD
• Scott Perry Keeley, MD

• Behavior Technician in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Behavior Technician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2024; 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.