Active NPI
John S Dickhudt, MD
- Family Medicine Physician
- Woodbury, MN
National Provider Identifier
1619982915
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 26215
- Practice address
- 8325 City Centre Dr
Woodbury, MN 55125-3323 - Phone
- (651) 731-0859
- Fax
- (651) 731-0976
- NPI assigned
- Jul 29, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 26215 | MN | Primary |
Addresses
Primary practice location
8325 City Centre Dr
Woodbury, MN 55125-3323
Mailing address
2025 Sloan PL Ste 35
Saint Paul, MN 55117-2092
Phone (651) 772-1572
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 599365200 | Medicaid | MN |
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 |
|---|---|---|---|
| 26215 | MN | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Minnhealth Family Physicians, P.a. | Family Medicine | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Family Medicine Physician
- White Bear Lake, MN
- NPI 1871710988
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154131200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1555286400000",
"number": "1619982915",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2025 SLOAN PL STE 35",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551172092",
"telephone_number": "651-772-1572",
"fax_number": "651-772-1889"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8325 CITY CENTRE DR",
"city": "WOODBURY",
"state": "MN",
"postal_code": "551253323",
"telephone_number": "651-731-0859",
"fax_number": "651-731-0976"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DICKHUDT",
"first_name": "JOHN",
"middle_name": "S",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-29",
"last_updated": "2019-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MN",
"license": "26215",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "599365200",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Woodbury, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.