Active NPI
Angela K Sidler, MD
- Pediatrics Physician
- Minneapolis, MN
National Provider Identifier
1487720595
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 42361
- Practice address
- 2525 Chicago Avenue South
Childrens Primary Care MPLS
Minneapolis, MN 55404 - Phone
- (612) 813-6107
- Fax
- (612) 813-7473
- NPI assigned
- Nov 28, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 42361 | MN | Primary |
Addresses
Primary practice location
2525 Chicago Avenue South
Childrens Primary Care MPLS
Minneapolis, MN 55404
Mailing address
2910 Centre Pointe Drive
35121A Childrens Health Care
Roseville, MN 55113
Phone (651) 855-2109
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 42361 | MN | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164672000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1487720595",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2910 CENTRE POINTE DRIVE",
"address_2": "35121A CHILDRENS HEALTH CARE",
"city": "ROSEVILLE",
"state": "MN",
"postal_code": "55113",
"telephone_number": "651-855-2109",
"fax_number": "651-855-2310"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2525 CHICAGO AVENUE SOUTH",
"address_2": "CHILDRENS PRIMARY CARE MPLS",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "55404",
"telephone_number": "612-813-6107",
"fax_number": "612-813-7473"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIDLER",
"first_name": "ANGELA",
"middle_name": "K",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MN",
"license": "42361",
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.