Individual provider Active NPI

Patricia Young Kohls, MD

  • Obstetrics & Gynecology Physician
  • Maplewood, MN
National Provider Identifier
1942220413
Registry record updated Sep 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
MN30624 Issued in MN
Practice address
1737 Beam Ave
Maplewood, MN 55109-2185
Phone
(651) 770-3320
Fax
(651) 770-3684
NPI assigned
Jul 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X MN30624 MN Primary

Addresses

Primary practice location

1737 Beam Ave
Maplewood, MN 55109-2185

Mailing address

1737 Beam Ave
Maplewood, MN 55109-2185
Phone (651) 770-3320

Other identifiers 1

IdentifierTypeStateIssuer
694790500MedicaidMN

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

LicenseStateTypeSpecialty
MN30624MNMDObstetrics & Gynecology Physician

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347321600000",
    "number": "1942220413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1737 BEAM AVE",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551092185",
            "telephone_number": "651-770-3320",
            "fax_number": "651-770-3684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1737 BEAM AVE",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551092185",
            "telephone_number": "651-770-3320",
            "fax_number": "651-770-3684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOHLS",
        "first_name": "PATRICIA",
        "middle_name": "YOUNG",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2012-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MN",
            "license": "MN30624",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "694790500",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maplewood, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2012; 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.