Amy A Kvidera, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

40487 Issued in MN

Practice address

618 N 9TH St
Saint Peter, MN 56082-1261

Phone

(507) 934-1211

NPI assigned

Jun 22, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Ea Health Physicians Medical Group - National LLC

  • Emergency Medicine Physician
  • San Diego, CA
  • NPI 1427322981
  NPD (past)
• Gundersen Clinic LTD

  • Clinic/Center
  • La Crosse, WI
  • NPI 1851343115
  NPD (past)

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

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408579200000",
    "number": "1639175896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "618 N 9TH ST",
            "city": "SAINT PETER",
            "state": "MN",
            "postal_code": "560821261",
            "telephone_number": "507-934-1211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "618 N 9TH ST",
            "city": "SAINT PETER",
            "state": "MN",
            "postal_code": "560821261",
            "telephone_number": "507-934-1211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KVIDERA",
        "first_name": "AMY",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-22",
        "last_updated": "2014-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "40487",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MN",
            "license": "40487",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32578400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jenny A Kortuem, MS CCC-SLP
• John Howard Krohn
• Ashley Krug, ATC
• Shannon Marie Kuball, LMFT
• Carol Jean Kuisle, LICSW
• Michael Joseph Lange, M.S., L.P.
• Kevin James Langton, LADC
• Tara Lynn Lassen, APRN
• Zacharias D Laughlin, LPCC
• Laura J. Hulsebus P.a. (Hulsebus Chiropractic)

• Family Medicine Physician in Saint Peter, MN
• Providers in Saint Peter, MN by specialty
• Family Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2014; 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.