FAIRVIEW HEALTH SERVICES (NPI# 1114152451) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114152451 |
| Entity Type | Organization |
| Organization Name | FAIRVIEW HEALTH SERVICES |
| Practice Address |
5200 Fairview Blvd Wyoming MN 55092-8013 |
| Practice Telephone | 6519827825 |
| Mailing Telephone | 6519827825 |
| Enumeration Date | 2009-05-15 |
| Last Update Date | 2020-06-03 |
| Authorized Official Name | ROBERT G OLSEN (PHYSICAL THERAPY ASSISTANT) |
| Authorized Official Telephone | 6512370494 |
| Authorized Official Credential | PTA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 283X00000X | Rehabilitation Hospital | A473 | MN | Hospitals |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104392398 | Fairview Health Services | Durable Medical Equipment & Medical Supplies | 1875 Woodwinds Dr Ste 150, Woodbury, MN 55125-2518 | 2018-10-16 |
| 1114492014 | Fairview Health Services | Durable Medical Equipment & Medical Supplies | 827 N 6th Ave, Virginia, MN 55792-2308 | 2018-10-06 |
| 1023583929 | Fairview Health Services | Durable Medical Equipment & Medical Supplies | 1101 E 37th St Ste 18, Hibbing, MN 55746-2973 | 2018-10-06 |
| 1316422397 | Fairview Health Services | General Practice | 7411 85th Ave N, Brooklyn Park, MN 55445-2231 | 2018-09-26 |
| 1972084044 | Fairview Health Services | Durable Medical Equipment & Medical Supplies | 1925 Woodwinds Dr Ste N1-055, Woodbury, MN 55125-4445 | 2018-08-27 |
| 1881141349 | Fairview Health Services | Physical Therapist | 3305 Central Park Village Drive, Suite 130, Eagan, MN 55121-7707 | 2016-09-01 |
| 1093960742 | Fairview Health Services | General Acute Care Hospital | 13017 Lakeview Dr, Burnsville, MN 55337-3857 | 2008-11-22 |
| 1104091131 | Fairview Health Services | Clinic/Center | 156 Cobblestone Ln, Burnsville, MN 55337-4578 | 2008-04-30 |
| 1184899486 | Fairview Health Services | Clinic/Center | 1230 School St Nw, Elk River, MN 55330-2422 | 2008-04-28 |
| 1467416677 | Fairview Health Services | Clinic/Center | 650 Taft St Ne, Ste 400, Minneapolis, MN 55413-2832 | 2006-04-14 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | FAIRVIEW HEALTH SERVICES | 2450 Riverside Ave, Minneapolis, MN 55454-1450 |
| Street Address |
5200 FAIRVIEW BLVD |
| City | WYOMING |
| State | MN |
| Zip Code | 55092-8013 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528061371 | Gunnar Jon Erickson | Ophthalmology | 5200 Fairview Blvd, Wyoming, MN 55092-8013 | 2005-05-24 |
| 1902414378 | Fairview Express Care | General Practice | 5200 Fairview Blvd, Wyoming, MN 55092-8013 | 2020-07-21 |
| 1023648235 | Cassandra L Etheridge | Physician Assistant | 5200 Fairview Blvd, Wyoming, MN 55092-8013 | 2020-01-16 |
| 1023652211 | Natasha Lackas | Speech-Language Pathologist | 5200 Fairview Blvd, Wyoming, MN 55092-8013 | 2019-10-31 |
| 1467019414 | Terrence Ellis | Clinical Exercise Physiologist | 5200 Fairview Blvd, Wyoming, MN 55092-8013 | 2019-05-24 |
| 1790341493 | Krystal Kraemer | Dietitian, Registered | 5200 Fairview Blvd, Wyoming, MN 55092-8013 | 2019-05-17 |
| 1225509037 | Lauren Downie | Dietitian, Registered | 5200 Fairview Blvd, Wyoming, MN 55092-8013 | 2018-12-06 |
| 1861977787 | Magdalen Rene Gadbois | Speech-Language Pathologist | 5200 Fairview Blvd, Wyoming, MN 55092-8013 | 2018-09-26 |
| 1285110338 | Marie Hudalla | Physical Therapist | 5200 Fairview Blvd, Wyoming, MN 55092-8013 | 2018-07-12 |
| 1023502697 | Molly Levy | Nurse Practitioner | 5200 Fairview Blvd, Wyoming, MN 55092 | 2018-06-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821696022 | Wyoming Family Dental | Dentist | 5378 East Viking Blvd., Wyoming, MN 55092 | 2020-10-12 |
| 1851909436 | Matthew Rohlf | Dentist | 5378 E Viking Blvd, Wyoming, MN 55092 | 2020-07-20 |
| 1669013280 | Christina Marie Orde | Technician | 4855 261st Street, Wyoming, MN 55092 | 2019-10-04 |
| 1609425966 | Faith Bouttell | Technician | 25423 Heims Lake Circle, Wyoming, MN 55092 | 2019-09-10 |
| 1275875031 | Fairview Express Care | Clinic/Center | 5130 Fairview Blvd, Suite 101, Wyoming, MN 55092 | 2013-03-20 |
| 1023385242 | St. Croix Orthopaedics, P.a. | Durable Medical Equipment & Medical Supplies | 5200 Fairview Blvd., Wyoming, MN 55092 | 2011-11-17 |
| 1902851876 | Tamara Piroska Petrac-halatsis | Obstetrics & Gynecology | 5200 Fairview Boulevard, Ob/gyn Department, Wyoming, MN 55092 | 2006-05-22 |
| 1376922070 | Carli Lynn Ceder | Physical Therapist | 5130 Fairview Blvd, Wyoming, MN 55092 | 2015-05-27 |
| 1396087433 | Fairview Health Services | Durable Medical Equipment & Medical Supplies | 5130 Fairview Blvd, Suite 104, Wyoming, MN 55092 | 2013-03-26 |
| 1598007726 | Fairview Health Services | Prosthetic/Orthotic Supplier | 5130 Fairview Blvd, Suite 103, Wyoming, MN 55092 | 2013-03-26 |
| Find all providers in zip 55092 | ||||
| Taxonomy Code | 283X00000X |
| Grouping | Hospitals |
| Classification | Rehabilitation Hospital |
| A hospital or facility that provides health-related, social and/or vocational services to disabled persons to help them attain their maximum functional capacity. |
| Notes: Source: Joint Commission on Accreditation of Healthcare Organizations, Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Oakbrook Terrace, IL: 1994, p. 323 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114391307 | Therese Ann Wengler | Rehabilitation Hospital | 1206 Niles Avenue, Saint Paul, MN 55116 | 2015-11-25 |
| 1649653965 | Samantha Hoy | Rehabilitation Hospital | 1467 Lake St S, 300, Forest Lake, MN 55025-4505 | 2015-07-06 |
| 1215272372 | Kimberly A Meegan | Rehabilitation Hospital | 1695 County Road D E Apt 132, Maplewood, MN 55109-5327 | 2012-11-30 |
| 1033403167 | Reflex Staffing | Rehabilitation Hospital | 4574 137th St W, Apple Valley, MN 55124-5211 | 2011-06-07 |
| 1821317116 | Reflex Services | Rehabilitation Hospital | 4574 137 Street West, Apple Valley, MN 55124 | 2010-05-26 |
| 1215130364 | Casey J Byron | Rehabilitation Hospital | 5242 Xerxes Ave S, Minneapolis, MN 55410-2447 | 2007-06-07 |
| 1205929981 | Minnesota Neurorehabilitaion Hospital | Rehabilitation Hospital | 11615 State Ave, Brainerd, MN 56401-7306 | 2006-10-02 |
| 1972055341 | Audra Lynn Taylor | Rehabilitation Hospital | 6401 France Ave S, Edina, MN 55435-2104 | 2016-11-01 |
| 1679959878 | Allina Health | Rehabilitation Hospital | 800 E 28th St, Minneapolis, MN 55407-3723 | 2015-08-11 |
| 1144548322 | University of Minnesota Medical Center, Fairview | Rehabilitation Hospital | 2450 Riverside Ave, Fco-4, Minneapolis, MN 55454-1450 | 2010-05-12 |
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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.