SOUTHDALE PHYSICIANS, LLC (NPI# 1124569249) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124569249 |
| Entity Type | Organization |
| Organization Name | SOUTHDALE PHYSICIANS, LLC |
| Practice Address |
6565 France Ave S Ste 350 Edina MN 55435-2137 |
| Practice Telephone | 6124308120 |
| Enumeration Date | 2017-03-09 |
| Last Update Date | 2017-03-10 |
| Authorized Official Name | MERLIN BROWN (PHYSICIAN/OWNER) |
| Authorized Official Telephone | 6124308120 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 38120 | MN | Allopathic & Osteopathic Physicians |
| Street Address |
6565 FRANCE AVE S STE 350 |
| City | EDINA |
| State | MN |
| Zip Code | 55435-2137 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386674547 | Deborah M. Nowak | Surgery | 6565 France Ave S Ste 350, Edina, MN 55435 | 2006-07-04 |
| 1043879901 | Rocket Surgery, LLC | Clinic/Center | 6565 France Ave S Ste 350, Edina, MN 55435-2159 | 2019-06-12 |
| 1811554629 | Kindred Health, LLC. | Nurse Practitioner | 6565 France Ave S Ste 350, Edina, MN 55435-2159 | 2019-05-28 |
| 1609389675 | Doctor's House | Clinic/Center | 6565 France Ave S Ste 350, Edina, MN 55435-2137 | 2017-11-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104433416 | Evy Christine Claussen | Social Worker | 6363 France Ave. S., Edina, MN 55435 | 2020-09-30 |
| 1508496621 | Samantha Jean Mcgough Lamere | Physician Assistant | 4300 Marketpointe Drive, Suite 100, Bloomington, MN 55435 | 2020-01-16 |
| 1659920460 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 3408 Galleria, Edina, MN 55435 | 2019-09-05 |
| 1730651639 | Taylor Lee Kehoe | Physician Assistant | 7400 France Ave., Suite #100, Edina, MN 55435 | 2018-12-18 |
| 1538666326 | Amanda Deangelo | Physical Therapist | 6401 Southdale Hospital, Ll3g, Edina, MN 55435 | 2018-04-09 |
| 1982107876 | Julia Seliber | Dental Hygienist | 7600 France Ave.s. Suite 1100, Edina, MN 55435 | 2018-03-16 |
| 1154840064 | Southhealth Asc, LLC | Clinic/Center | 4100 Minnesota Drive, Edina, MN 55435 | 2017-09-12 |
| 1730605528 | Edina Medical Supplies | Durable Medical Equipment & Medical Supplies | 7455 France Ave., #614 S, Edina, MN 55435 | 2017-08-14 |
| 1033565510 | Minnesota Disc Replacement and Spine Restoration Center | Clinic/Center | 4444 76 St, #700, Edina, MN 55435 | 2016-05-13 |
| 1306206321 | Barb Ryan | Mechanotherapist | 7550 France Avenue S, #220, Edina, MN 55435 | 2016-03-03 |
| Find all providers in zip 55435 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023644069 | Jeffrey Howard Mandel | Internal Medicine | 6204 Westridge Blvd, Edina, MN 55436-2569 | 2020-03-22 |
| 1164718607 | Christine Nichole Desautels | Internal Medicine | 8100 W. 78th St. #100, Edina, MN 55439-2529 | 2011-06-23 |
| 1598887895 | Ahmad Raza | Internal Medicine | 6363 France Ave S Ste 610, Edina, MN 55435-2144 | 2007-04-06 |
| 1427118975 | Noelle M Nelson | Internal Medicine | 8100 W 78th St # St100, Edina, MN 55439-2516 | 2006-12-12 |
| 1962583658 | Jean Ruth Eckerly | Internal Medicine | 5808 Zenith Ave S, Edina, MN 55410-2832 | 2006-10-18 |
| 1578518767 | Mary Jane Setterberg | Internal Medicine | 6700 France Ave S Ste 300, Edina, MN 55435-1908 | 2006-05-24 |
| 1871554048 | Kathleen M Ayaz | Internal Medicine | 8100 W 78th St Ste 100, Edina, MN 55439-2529 | 2006-03-29 |
| 1003809898 | Mohammad H Arbabi | Internal Medicine | 6500 France Ave S, Edina, MN 55435-1700 | 2005-08-26 |
| 1972509255 | David J Walcher | Internal Medicine | 6545 France Avenue South, Suite 510, Edina, MN 55435 | 2005-06-22 |
| 1578569042 | Paul S. Gotlieb | Internal Medicine | 6545 France Ave S, Suite 150, Edina, MN 55435-2131 | 2005-06-21 |
| Find all providers in EDINA | ||||
Please comment or provide details below to improve the information on SOUTHDALE PHYSICIANS, LLC.
| 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.