KEITH BRYAN CORDNER JR. MD
NPI 1558059337
Student in an Organized Health Care Education/Training Program in Minneapolis, MN

Q: What is Keith Cordner's NPI number?

The NPI number for Keith Cordner is 1558059337. It was assigned to this individual provider in the NPPES registry on April 28, 2023.

Q: What is Keith Cordner's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Keith Cordner was last updated on April 29, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 28, 2023PECOS Enrolled

2450 RIVERSIDE AVE, MINNEAPOLIS, MN 55454(612) 273-8383 Get Directions Write a Review

NPPES record last updated: April 29, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Keith Bryan Cordner Jr. Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KEITH BRYAN CORDNER JR. MD (NPI 1558059337) is an individual student in an organized health care education/training program in Minneapolis, Minnesota and active in the NPI registry since April 2023. He is enrolled in Medicare PECOS and is a graduate of Other (2023).

NPPES Registry Identity

NPI1558059337

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameKEITH BRYAN CORDNER JR.Credential: MD

Location Address2450 RIVERSIDE AVEMinneapolis, MN 55454-1450

Mailing Address420 Delaware St SeMinneapolis, MN 55455-0341

Phone(612) 273-8383

Sole ProprietorNo

Medical School CMSOtherGraduated 2023

Enumeration DateApril 28, 2023

Last NPPES UpdateApril 29, 2024

NPPES CertifiedApril 29, 2024

✔ NPI 1558059337 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

2450 RIVERSIDE AVE, Minneapolis, MN 55454

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Keith Bryan Cordner Jr. Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID2365801958

PECOS Enrollment IDI20260605001866

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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Rehabilitation Practitioner