Katelyn Marie Adams, MD
Individual provider Active NPI Pediatrics Physician · Duluth, MN
NPI 1689237448 · NPPES record last updated Jul 6, 2022
Key facts
- NPI
- 1689237448
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 71122 (MN)
- Practice address
- 420 E 1St St
Duluth, MN 55805-1901 - Phone
- (218) 786-8364
- NPI assigned
- Apr 17, 2019
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220720002072 | MN | Practitioner - Pediatric Medicine | 4789918970 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71122 | MN | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Duluth Clinic, LTD | Current | Accepting new patients | |
| The Duluth Clinic LTD | Current | Accepting new patients | |
| The Duluth Clinic LTD | Current |
Accepting new patients | |
| The Duluth Clinic, LTD. | Current |
Accepting new patients | |
| The Duluth Clinic, LTD | Past | Accepting new patients |
Locations
420 E 1st St
Duluth, MN 55805
Phone (218) 786-1265
400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364
4855 W Arrowhead Rd
Hermantown, MN 55811
Phone (218) 786-3540
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 71122 | MN | Yes |
Addresses
Primary practice location
420 E 1St St
Duluth, MN 55805-1901
Mailing address
400 E 3Rd St
Duluth, MN 55805-1951
Phone (218) 786-8364
Other providers in Duluth, MN
- Peter Joseph Ackerman
- Jessica Acuna
- Debra L Adams-Koltes
- Jane Goldfarb Adams
- Jeffrey Lyndon Adams
- Parker Gibson Adams
- Ruuney Adani
- Amina Adil
- Leslie Adrian
- Brian Joseph Aebly
All providers in Duluth, MN · Pediatrics Physician in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 6, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.