HEALTHEAST MEDICAL RESEARCH INSTITUTE DBA HEALTHEAST PHYSICIAN SERVICE (NPI# 1073569943) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073569943 |
| Entity Type | Organization |
| Organization Name | HEALTHEAST MEDICAL RESEARCH INSTITUTE DBA HEALTHEAST PHYSICIAN SERVICE |
| Other Organization Name | HEALTHEAST NEONATAL SERVICES |
| Practice Address |
3100 Kennard St Suite 100 Maplewood MN 55109-4569 |
| Practice Telephone | 6512327031 |
| Practice Fax Number | 6512327826 |
| Mailing Telephone | 6512327031 |
| Mailing Fax Number | 6512327826 |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2015-05-20 |
| Authorized Official Name | DOUG DAVENPORT (CFO) |
| Authorized Official Telephone | 6512322250 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 250223200 | 05 |
| Other Name | Type Code |
|---|---|
| HealthEast Neonatal Services | Other Name - Individual/Organization |
| Street Address |
3100 KENNARD ST SUITE 100 |
| City | MAPLEWOOD |
| State | MN |
| Zip Code | 55109-4569 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598756157 | William B Hicks | Allergy & Immunology | 3100 Kennard St, Maplewood, MN 55109-5439 | 2005-11-02 |
| 1316495401 | Thomas Grove Wilson | Nurse Practitioner | 3100 Kennard St, Suite 100, Maplewood, MN 55109-5465 | 2016-09-16 |
| 1982842290 | Healtheast Care System | Non-Pharmacy Dispensing Site | 3100 Kennard St, 100, Maplewood, MN 55109-4569 | 2009-01-23 |
| 1003014911 | John Paul Berger | Internal Medicine | 3100 Kennard St, Suite 250, Maplewood, MN 55109-5465 | 2007-07-03 |
| 1770600884 | Stephanie J Fox | Allergy & Immunology | 3100 Kennard St, Maplewood, MN 55109-5465 | 2007-03-23 |
| 1902986698 | Carol Lu | Internal Medicine | 3100 Kennard St, Ste 100, Maplewood, MN 55109-5465 | 2006-10-17 |
| 1568559888 | Christopher Neville Ussher | Internal Medicine | 3100 Kennard St, Maplewood, MN 55109-5465 | 2006-10-06 |
| 1396859468 | Jeanne Mackenzie Goodspeed | Pediatrics | 3100 Kennard St, Maplewood, MN 55109 | 2006-08-18 |
| 1467497610 | Kent Davis Bergh | Family Medicine | 3100 Kennard St, Suite 100 Healtheast Physician Service, Maplewood, MN 55109 | 2006-06-19 |
| 1437198694 | Thomas G Dashiell | Internal Medicine | 3100 Kennard St, Ste 100, Maplewood, MN 55109-5465 | 2006-06-05 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366063828 | Jodi May Begordis | Registered Nurse | 2586 7th Ave East, Suite 302, North St Paul, MN 55109 | 2020-05-06 |
| 1467917146 | Alejandro Diez Freire | Social Worker | 2468 Germain St, Maplewood, MN 55109 | 2019-02-06 |
| 1679099667 | Rochelle Marie Clarke | Registered Nurse | 2586 7th Ave East Suite 302, North Saint Paul, MN 55109 | 2017-08-21 |
| 1497298210 | Salams Care Residential, LLC | Home Health | 2240 Ide Ct, Maplewood, MN 55109 | 2016-11-28 |
| 1093199630 | Garry Allen | Psychologist | 2345 Ariel St North Mail Stop 13601a, Maplewood, MN 55109 | 2015-07-14 |
| 1700264751 | Matthew Seng Thao | Student in an Organized Health Care Education/Training Program | 1470 Gervais Ave, Maplewood, MN 55109 | 2015-05-11 |
| 1326458340 | Chong Chang | Counselor | 1705 Cope Ave E Ste I, Maplewood, MN 55109 | 2014-04-29 |
| 1619396488 | Leah Anne Downey | Occupational Therapist | 2399 Ariel St. N., Children's Theraplay, LLC, Maplewood, MN 55109 | 2014-04-09 |
| 1356765440 | Group Health Plan, Inc | Clinic/Center | 2520 12th Ave E, North St Paul, MN 55109 | 2014-02-10 |
| 1336560275 | Veneman Dental Care, Pa | Dentist | 1774 Cope Ave, Suite 110, Maplewood, MN 55109 | 2013-12-19 |
| Find all providers in zip 55109 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013460468 | Premier Healthcare Group | Clinic/Center | 90 Midland Blvd, Maplewood, NJ 07040-1810 | 2016-08-02 |
| 1932640380 | Asya Rivinson, Lcsw, PC | Clinic/Center | 697 Valley St Ste B1, Maplewood, NJ 07040-2645 | 2017-03-19 |
| 1780094128 | Asya Rivinson Lcsw PC | Clinic/Center | 697 Valley St, Suite B1, Maplewood, NJ 07040-2641 | 2014-05-07 |
| 1144526930 | Allina Health System | Clinic/Center | 1850 Beam Ave, Maplewood, MN 55109-1162 | 2011-01-27 |
| 1942443379 | Family First Chiropractic & Wellness Center | Clinic/Center | 2485 Maplewood Dr, Suite 215, Maplewood, MN 55109-1978 | 2009-04-15 |
| 1285809590 | Fairview Health Services | Clinic/Center | 2355 Ariel St N, Ste B, Maplewood, MN 55109-2275 | 2008-04-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871191403 | Cham Clinic LLC | Clinic/Center | 7362 University Ave Ne Ste 206, Fridley, MN 55432-3151 | 2020-10-15 |
| 1003434622 | Lost Lake Optical Company | Clinic/Center | 5240 Shady Island Cir, Mound, MN 55364-9222 | 2020-07-09 |
| 1811513310 | Prescribed By LLC | Clinic/Center | 701 Washington Ave N Ste 111-321, Minneapolis, MN 55401-2822 | 2020-06-19 |
| 1992320014 | Jtp Professional Service Corporation | Clinic/Center | 2038 Ford Pkwy # 444, Saint Paul, MN 55116-1931 | 2020-06-15 |
| 1689299125 | Altru Health System | Clinic/Center | 1st & Roosevelt, Karlstad, MN 56732 | 2020-06-10 |
| 1831710409 | Webmed LLC | Clinic/Center | 925 E Superior St Ste 113, Duluth, MN 55802-2253 | 2020-05-05 |
| 1073149779 | Functional Chiropractic Rehab, Pllc | Clinic/Center | 1901 Madison Ave Ste 120, Mankato, MN 56001-6267 | 2020-03-14 |
| 1225676067 | Liana Healthcare P.ll.c | Clinic/Center | 8348 Beard Rd, Bloomington, MN 55431-1028 | 2019-12-11 |
| 1245875293 | Fairview Clinics | Clinic/Center | 12912 Farnham Ave N, White Bear Lake, MN 55110-5929 | 2019-11-14 |
| 1275175242 | Hye-kyong Kim Therapy LLC | Clinic/Center | 1145 Grand Ave # 101, Saint Paul, MN 55105-2629 | 2019-10-11 |
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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.