Individual provider Active NPI

Kirsten Kathleen Rydberg, RN

  • Emergency Registered Nurse
  • Minneapolis, MN
National Provider Identifier
1407353519
Registry record updated Apr 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Registered NurseTaxonomy code 163WE0003X
License
2096313 Issued in MN
Practice address
One Veteran Drive
Minneapolis, MN 55417
Phone
(612) 467-4335
NPI assigned
Apr 6, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Registered Nurse 163WE0003X 2096313 MN Primary

Addresses

Primary practice location

One Veteran Drive
Minneapolis, MN 55417

Mailing address

263 Johnson Pkwy
Saint Paul, MN 55106-6409
Phone (651) 307-5730

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
2096313MNMDEmergency Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1522972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522972800000",
    "number": "1407353519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "263 JOHNSON PKWY",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551066409",
            "telephone_number": "651-307-5730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ONE VETERAN DRIVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55417",
            "telephone_number": "612-467-4335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYDBERG",
        "first_name": "KIRSTEN",
        "middle_name": "KATHLEEN",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-06",
        "last_updated": "2018-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "MN",
            "license": "2096313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2018; 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.