PARK NICOLLET- METHODIST HOSPITAL (NPI# 1104136142) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104136142 |
| Entity Type | Organization |
| Organization Name | PARK NICOLLET- METHODIST HOSPITAL |
| Practice Address |
6500 Excelsior Blvd St Louis Park MN 55426-4702 |
| Mailing Address |
1521 Highland Pkwy Saint Paul MN 55116-2241 |
| Practice Telephone | 9529933123 |
| Enumeration Date | 2010-10-08 |
| Last Update Date | 2010-10-08 |
| Authorized Official Name | TED SPOONER (CT SURGERY) |
| Authorized Official Telephone | 9529933123 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282N00000X | General Acute Care Hospital | Hospitals |
| Street Address |
6500 EXCELSIOR BLVD |
| City | ST LOUIS PARK |
| State | MN |
| Zip Code | 55426-4702 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861484669 | Robert E Haselow | Radiology | 6500 Excelsior Blvd, Methodist Radiation Therapy, St Louis Park, MN 55426-4702 | 2005-08-17 |
| 1215549381 | Katelyn Boys | Physical Therapist | 6500 Excelsior Blvd, St Louis Park, MN 55426-4702 | 2020-08-20 |
| 1386253466 | Christine Harlander | Physical Therapist | 6500 Excelsior Blvd, St Louis Park, MN 55426-4700 | 2020-07-24 |
| 1063021210 | Ian-thomas Campbell-groen | Physical Therapist | 6500 Excelsior Blvd, St Louis Park, MN 55426-4700 | 2020-07-23 |
| 1619585387 | Kelly Faber | Physical Therapist | 6500 Excelsior Blvd, St Louis Park, MN 55426-4702 | 2020-07-20 |
| 1952938821 | Paige Rygg | Physical Therapist | 6500 Excelsior Blvd, St Louis Park, MN 55426-4702 | 2020-03-23 |
| 1801427406 | Brandi Jo St. Mane | Nurse Anesthetist, Certified Registered | 6500 Excelsior Blvd, St Louis Park, MN 55426-4702 | 2020-02-01 |
| 1811528680 | Brian Servey IIi | Nurse Anesthetist, Certified Registered | 6500 Excelsior Blvd, St Louis Park, MN 55426-4702 | 2020-01-30 |
| 1245873421 | Weston Poucher | Nurse Anesthetist, Certified Registered | 6500 Excelsior Blvd, St Louis Park, MN 55426-4700 | 2019-10-21 |
| 1427609973 | Lauren Damrow | Registered Nurse | 6500 Excelsior Blvd, St Louis Park, MN 55426-4700 | 2019-09-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821657545 | Big Brain Concussion Recovery & Chiropractic Pa | Chiropractor | 3313 Republic Ave., St. Louis Park, MN 55426 | 2019-06-06 |
| 1912485095 | Daniel Raies | Optometrist | 8900 Minnesota 7, St Louis Park, MN 55426 | 2018-08-01 |
| 1649756040 | Wayside House, Inc. | Clinic/Center | 1349 Jersey Ave S, St. Louis Park, MN 55426 | 2018-07-18 |
| 1104302884 | Superior Caregivers, LLC | In Home Supportive Care | 1319 Lancaster Ave., St. Louis Park, MN 55426 | 2018-07-16 |
| 1396234266 | Caitlin Kwiatkowski | Behavior Technician | 7010 Mn-7, St.louis Park, MN 55426 | 2018-05-07 |
| 1497244313 | Kelly Ann Clancey | Behavior Technician | 7010 Highway 2, Saint Louis Park, MN 55426 | 2018-05-07 |
| 1770072696 | Ashleigh Hakala | Behavior Technician | 7010 Highway 7 St. Louis Park Mn 55426, St. Louis Park, MN 55426 | 2018-05-07 |
| 1689181521 | Glenda Miles | Registered Nurse | 7316 Cedar Lake Road, Apt 8, St Louis Park, MN 55426 | 2017-12-31 |
| 1174041875 | Kristen Webb | Physician Assistant | 3931 Louisiana Ave S, Suite E-500, St. Louis Park, MN 55426 | 2017-09-01 |
| 1447775549 | Belinda Sue Bliss | Marriage & Family Therapist | 3301 Decatur Lane, Saint Louis Park, MN 55426 | 2017-08-09 |
| Find all providers in zip 55426 | ||||
| Taxonomy Code | 282N00000X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245615772 | Park Nicollet Methodist Hospital | General Acute Care Hospital | 6500 Excelsior Blvd, St Louis Park, MN 55426-4702 | 2015-07-27 |
| 1194113217 | Park Nicollet Methodist Hospital | General Acute Care Hospital | 3900 Park Nicollet Blvd, St Louis Park, MN 55416-2503 | 2014-12-23 |
| 1114278876 | Joseph Stephen Henefield | General Acute Care Hospital | 6500 Excelsior Blvd, St Louis Park, MN 55426-4702 | 2012-09-20 |
| 1942585286 | Park Nicollet Methodist Hospital | General Acute Care Hospital | 3525 Monterey Dr, St Louis Park, MN 55416-5275 | 2011-10-19 |
| 1649220724 | Park Nicollet Methodist Hospital | General Acute Care Hospital | 6500 Excelsior Blvd, St Louis Park, MN 55426 | 2006-05-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811372360 | Karin Costin | General Acute Care Hospital | 803 E 28th St, Minneapolis, MN 55407 | 2015-07-27 |
| 1619317070 | Allegheny General Hospital | General Acute Care Hospital | 724 4th St Sw, Rochester, MN 55902-2913 | 2013-07-01 |
| 1003196361 | Fairview | General Acute Care Hospital | 21282 Inspiration Ct, Lakeville, MN 55044-6027 | 2011-08-18 |
| 1356652481 | Spectrum Health | General Acute Care Hospital | 25850 Brolin Beach Rd, Detroit Lakes, MN 56501-7978 | 2010-06-23 |
| 1093960742 | Fairview Health Services | General Acute Care Hospital | 13017 Lakeview Dr, Burnsville, MN 55337-3857 | 2008-11-22 |
| 1144477282 | Allina Home Care Hospice and Palliative Care | General Acute Care Hospital | 1055 Westgate Dr. Suite 100, St. Paul, MN 55114-1451 | 2008-08-20 |
| 1104029388 | Shannon Carl Nelson | General Acute Care Hospital | Highway 1 Box 497, Red Lake, MN 56671 | 2007-06-06 |
| 1356559983 | Rtgmedical | General Acute Care Hospital | 2186 Baneberry Way W, Chanhassen, MN 55317 | 2007-05-18 |
| 1730232307 | Jack Ramon Lees | General Acute Care Hospital | 2146 Lemay Lake Dr, Mendota Heights, MN 55120-1183 | 2007-01-18 |
| 1245349257 | Russell Vincent Luepker | General Acute Care Hospital | 1300 S 2nd St, Suite 300, Minneapolis, MN 55454-1075 | 2006-08-30 |
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| City | ST LOUIS PARK |
| Zip Code | 55426 |
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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.