Individual provider Active NPI

Cade Kerry, LICSW, LISW

  • Clinical Social Worker
  • Saint Paul, MN
National Provider Identifier
1396366506
Registry record updated Sep 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
1877 Bush Ave E
Saint Paul, MN 55119-3423
Phone
(513) 315-9186
NPI assigned
Apr 28, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X MN Primary

Addresses

Primary practice location

1877 Bush Ave E
Saint Paul, MN 55119-3423

Mailing address

1019 Linn St
Cincinnati, OH 45203-1314

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241104000042 MN Practitioner - Clinical Social Worker 0143753830 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
31643MNMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System Current Accepting new patients
Allina Health System CurrentSince Oct 14, 2024 Accepting new patients
Allina Health System CurrentSince Oct 14, 2024 Accepting new patients

Locations

520 Osborne Rd NE
Ste 120
Fridley, MN 55432
Phone (763) 236-4300

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

Interoperability endpoints

  • Direct secure messaging: ckerry673989@excellian.direct.allina.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1588032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1396366506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1019 LINN ST",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452031314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1877 BUSH AVE E",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551193423",
            "telephone_number": "513-315-9186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERRY",
        "first_name": "CADE",
        "credential": "LICSW, LISW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-28",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.