Kenneth A Adams, MD
Individual provider Active NPI Specialist · Minneapolis, MN
NPI 1528060886 · NPPES record last updated Mar 11, 2021
Key facts
- NPI
- 1528060886
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- MD103273 (MO)
- Practice address
- 2925 Chicago Ave
Minneapolis, MN 55407-1321 - Phone
- (612) 262-4000
- NPI assigned
- Jun 1, 2005
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD103273 | MO | MD | Specialist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | MD103273 | MO | Yes |
Addresses
Primary practice location
2925 Chicago Ave
Minneapolis, MN 55407-1321
Mailing address
2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (612) 262-5000
Other practice location 1
19550 E 39th St S
Ste 310
Independence, MO 64057-2303
Phone (816) 350-1200
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 160021081 | Other | MS | MEDICARE RR |
| 19545016 | Other | MO | BCBS |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kadams318581@excellian.direct.allina.com | Direct |
Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 11, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.