Kenneth Wayne Dodd, MD

Primary specialty

Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X

License

57200 Issued in MN

Practice address

715 S 8TH St
Minneapolis, MN 55404-7530

Phone

(612) 873-6963

NPI assigned

Apr 25, 2012

Last updated

Dec 19, 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 2

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in MN, IL2 enrollments

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 2

Specialty

Emergency MedicineAlso: Critical Care (Intensivists), Internal Medicine

Education

University of Minnesota Medical School, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Suburban Emergency Associates PAGroup PAC ID 8325950975, 20 clinicians

Hennepin Healthcare System IncGroup PAC ID 4789684861, 905 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hennepin County Medical Center Hospital, Minneapolis, MN, CCN 240004
• St Francis Regional Medical Center Hospital, Shakopee, MN, CCN 240104

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kdodd217697@direct.myadvocateaurora.org

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.

• Hennepin Healthcare System, Inc

  dba Hennepin County Medical Center

  • Rehabilitation Hospital Unit
  • Minneapolis, MN
  • NPI 1033138136
  Medicare reassignment Care Compare group NPD
• Suburban Emergency Associates, P.a.

  • Nurse Practitioner
  • Shakopee, MN
  • NPI 1134173628
  Medicare reassignment Care Compare group
• Cuyuna Regional Medical Center

  dba Longville Lakes Clinic

  • Family Medicine Physician
  • Longville, MN
  • NPI 1861414518
  Medicare reassignment NPD
• Advocate Health and Hospitals Corporation

  dba Advocate Intensivist Partners

  • Critical Care Medicine (Internal Medicine) Physician
  • Oak Lawn, IL
  • NPI 1629441027
  Medicare reassignment NPD
• Advocate Health and Hospitals Corporation

  dba Advocate Medical Group

  • Multi-Specialty Clinic/Center
  • Oak Brook, IL
  • NPI 1700824455
  Medicare reassignment NPD
• Cuyuna Regional Medical Center

  • Critical Access Hospital
  • Crosby, MN
  • NPI 1538143896
  Medicare reassignment
• Cuyuna Regional Medical Center

  • Critical Access Hospital Clinic/Center
  • Crosby, MN
  • NPI 1639459282
  NPD
• Hennepin Healthcare System Inc

  dba HCMC Specialty Services Pharmacy

  • Specialty Pharmacy
  • Minneapolis, MN
  • NPI 1619567625
  NPD
• Hennepin Healthcare System, Inc

  dba Hennepin County Medical Center

  • General Acute Care Hospital
  • Minneapolis, MN
  • NPI 1407897309
  NPD
• Advocate Health and Hospitals Corporation

  dba Advocate Children's Hospital

  • Children's Hospital
  • Oak Lawn, IL
  • NPI 1508315516
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Hennepin Healthcare System, Inc

  dba Hennepin County Medical Center

  • General Acute Care Hospital
  • Minneapolis, MN
  • NPI 1407897309
  Care Compare affiliation
• St Francis Regional Medical Center

  • General Acute Care Hospital
  • Shakopee, MN
  • NPI 1578520045
  Care Compare affiliation

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

{
    "created_epoch": "1335312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734566400000",
    "number": "1477811610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 PARK AVENUE",
            "address_2": "HENNEPIN COUNTY MEDICAL CENTER",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554151623",
            "telephone_number": "612-873-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 S 8TH ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554047530",
            "telephone_number": "612-873-6963"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4440 W 95th St",
            "address_purpose": "LOCATION",
            "city": "Oak Lawn",
            "state": "IL",
            "postal_code": "604532600",
            "country_code": "US",
            "telephone_number": "708-684-5354",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "701 Park Avenue",
            "address_2": "Hennepin County Medical Center",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "55415",
            "country_code": "US",
            "telephone_number": "612-873-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DODD",
        "first_name": "KENNETH",
        "middle_name": "WAYNE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-25",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "IL",
            "license": "036145260",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "MN",
            "license": "57200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kdodd217697@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4440 W 95th St",
            "city": "Oak Lawn",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604532600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "4440 W 95th St",
            "city": "Oak Lawn",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604532600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Benjamin Dockter
• Kathryn Mackenzie Dockter
• Tonia R Dockter, RD, LD
• Chelsi Lynn Dodd, AUD
• Kendra Dodd, M.D.
• Rachel Cournoyer Dodd, RN
• Michele Frances Dodds, PHD, LP
• Amy Dodge
• Jessica K Dodge, PHD, LP, BCBA
• Taiwo Seun Dodo-Williams, MD

• Critical Care Medicine (Internal Medicine) Physician in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Critical Care Medicine (Internal Medicine) Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2024; 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.