John Kidd, CNA

Primary specialty

Home Health AideTaxonomy code 374U00000X

License

10761063 Issued in MN

Practice address

6237 Rivlyn Ave NW
Ramsey, MN 55303-4538

Phone

(612) 412-4661

NPI assigned

Jan 23, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1642896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642896000000",
    "number": "1992457717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6237 RIVLYN AVE NW",
            "city": "RAMSEY",
            "state": "MN",
            "postal_code": "553034538",
            "telephone_number": "612-412-4661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6237 RIVLYN AVE NW",
            "city": "RAMSEY",
            "state": "MN",
            "postal_code": "553034538",
            "telephone_number": "612-412-4661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIDD",
        "first_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "CNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-01-23",
        "last_updated": "2022-01-23",
        "certification_date": "2022-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "MN",
            "license": "10761063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Health Aide in Ramsey, MN
• Providers in Ramsey, MN by specialty
• Home Health Aide in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2022; 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.