NPIMap

Individual provider Active NPI

Emily Marie Kidd, MD

  • Family Medicine Physician
  • Brooklyn Park, MN
National Provider Identifier
1760827463
Registry record updated Mar 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
58374 Issued in MN
Practice address
9300 Noble Pkwy N
Brooklyn Park, MN 55443-5500
Phone
(763) 236-5300
Fax
(763) 236-5250
NPI assigned
May 8, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 58374 MN Primary

Addresses

Primary practice location

9300 Noble Pkwy N
Brooklyn Park, MN 55443-5500

Mailing address

9300 Noble Pkwy N
Brooklyn Park, MN 55443-5500
Phone (763) 236-5300

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ekidd317261@excellian.direct.allina.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140930001856 MN Practitioner - Family Practice 5991925745 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Boston University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Allina Health SystemGroup PAC ID 4587573613, shared by 89 NPIs, 3,844 clinicians

Practice addresses (Care Compare)

9300 Noble Pkwy N
Brooklyn Park, MN 55443-5500
Phone (763) 236-5300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System Current Accepting new patients
Allina Health System CurrentSince Aug 29, 2016 Accepting new patients
Allina Health System CurrentSince Dec 31, 2022 Accepting new patients
Allina Health System Family Medicine Current Accepting new patients
Allina Health System CurrentSince Aug 29, 2016 Accepting new patients
Allina Health System Family Medicine Past Accepting new patients

Locations

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

9300 Noble Pkwy N
Minneapolis, MN 55443
Phone (763) 236-5300

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

Organizations & group practices 6

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.

Hospital & facility affiliations 34

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1367971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615420800000",
    "number": "1760827463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9300 NOBLE PKWY N",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554435500",
            "telephone_number": "763-236-5300",
            "fax_number": "763-236-5250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9300 NOBLE PKWY N",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554435500",
            "telephone_number": "763-236-5300",
            "fax_number": "763-236-5250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIDD",
        "first_name": "EMILY",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-08",
        "last_updated": "2021-03-11",
        "certification_date": "2021-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "58374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ekidd317261@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "9300 Noble Pkwy N",
            "city": "Brooklyn Park",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554435500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Brooklyn Park, MN

Sources for this page

Verify at the official NPI Registry.