SUMMIT ORTHOPEDICS LTD (NPI# 1053955385) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053955385 |
| Entity Type | Organization |
| Organization Name | SUMMIT ORTHOPEDICS LTD |
| Practice Address |
4360 12th Ave E Shakopee MN 55379-1955 |
| Mailing Address |
710 Commerce Dr Ste 200 Woodbury MN 55125-4925 |
| Practice Telephone | 6519685200 |
| Mailing Telephone | 6519685200 |
| Enumeration Date | 2019-10-30 |
| Last Update Date | 2019-10-30 |
| Authorized Official Name | JOHN BIEN (CFO) |
| Authorized Official Telephone | 6519685870 |
| Is Organization Subpart | Y |
| Parent Organization Name | SUMMIT ORTHOPEDICS LTD |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Summit Orthopedics - Shakopee Clinic | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811973639 | Summit Orthopedics Ltd | Clinic/Center | 7115 Tamarack Rd Ste 200, Woodbury, MN 55125-1208 | 2005-12-22 |
| 1558870196 | Summit Orthopedics Ltd | Clinic/Center | 710 Commerce Dr Ste 200, Woodbury, MN 55125-4925 | 2017-09-27 |
| Street Address |
4360 12TH AVE E |
| City | SHAKOPEE |
| State | MN |
| Zip Code | 55379-1955 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124657549 | Mackenzie Ann Loutzenhiser | Physician Assistant | 4360 12th Ave E, Shakopee, MN 55379-1955 | 2020-04-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073123030 | True North Community Dental Clinic, LLC | Dentist | 415 East First Avenue, Shakopee, MN 55379 | 2020-08-05 |
| 1154988236 | Benedictine Living Community of Shakopee LLC | Assisted Living Facility | 1705 Windermere Way, Shakopee, MN 55379 | 2019-05-23 |
| 1346741394 | Expressions In Motion LLC | Speech-Language Pathologist | 1221 East 4th Ave., Shakopee, MN 55379 | 2018-02-26 |
| 1124529334 | A.m Dental Professionals P.a | Clinic/Center | 1036 1st Ave E, Shakopee, MN 55379 | 2018-02-22 |
| 1538522024 | Jesse Sylvester | Chiropractor | 1275 Ramsey Street South, #600, Shakopee, MN 55379 | 2016-04-01 |
| 1376903963 | Dakota Best Transportation LLC | Non-emergency Medical Transport (VAN) | 449 Dakota Street Apt 2, Shakopee, MN 55379 | 2016-02-25 |
| 1568856631 | Tatyana Mishkin Gleyzer | Nurse Practitioner | 1010 West Sixth Avenue, Shakopee, MN 55379 | 2015-03-26 |
| 1245634039 | Kalli Ledel | Pharmacist | 1198 Vierling Dr, Cub Pharmacy, Shakopee, MN 55379 | 2014-10-22 |
| 1487992913 | Jennifer Elizabeth Boyd | Nurse Practitioner | Pediatrics 1415 St Francis Ave, Park Nicollet Clinic-shakopee, Shakopee, MN 55379 | 2013-01-17 |
| 1013253798 | Acts Therapy LLC | Counselor | 8170 Old Carriage Court North, 215, Shakopee, MN 55379 | 2012-12-27 |
| Find all providers in zip 55379 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760467856 | Darren F Larson | Orthopaedic Surgery | 1601 Saint Francis Ave, Shakopee, MN 55379-3383 | 2005-12-12 |
| 1629482708 | Grant William Mathison | Orthopaedic Surgery | 1415 Saint Francis Ave, Shakopee, MN 55379-3374 | 2014-06-17 |
| 1134179419 | David Conrad Carlson | Orthopaedic Surgery | 1515 Saint Francis Ave, Suite 150, Shakopee, MN 55379-3387 | 2006-05-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639631526 | Multiple Care of Mn, LLC | Orthopaedic Surgery | 8500 Normandale Lake Blvd Ste 350, Bloomington, MN 55437-3805 | 2019-04-01 |
| 1073933719 | Nicholas Adam Lesmeister | Orthopaedic Surgery | 2014 South 6th Street, Brainerd, MN 56401 | 2014-04-21 |
| 1477971174 | Thomas Jay Kaiser | Orthopaedic Surgery | 35 State Ave Ste 1, Faribault, MN 55021-6369 | 2014-03-31 |
| 1073876876 | Daniel Borgen | Orthopaedic Surgery | 1811 Pennsylvania Ave N, Golden Valley, MN 55427-4015 | 2012-06-18 |
| 1194019729 | John Allen Wilson Jr. | Orthopaedic Surgery | 7327 Rogers Point Rd Nw, Walker, MN 56484-2523 | 2011-05-31 |
| 1952693749 | Kurt Joseph Duncan | Orthopaedic Surgery | 8650 Hudson Blvd N Ste 100, Lake Elmo, MN 55042-8416 | 2011-05-11 |
| 1407155054 | Paul T. Wicklund, M.d., P.a. | Orthopaedic Surgery | 6545 France Ave S Ste 363, Edina, MN 55435-2121 | 2011-03-22 |
| 1861712861 | Wayne William Thompson | Orthopaedic Surgery | 1651 Saunders Ave, Saint Paul, MN 55116-2430 | 2010-06-02 |
| 1124357512 | William Jarvis Busby | Orthopaedic Surgery | 501 Holly Cir, Wayzata, MN 55391-1369 | 2009-12-14 |
| 1407184070 | Gary A Matthys Md Plc | Orthopaedic Surgery | 129 E Lincoln Ave, Fergus Falls, MN 56537-2283 | 2009-11-19 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.