MEGAN STARK (NPI# 1154796811) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154796811 |
| Entity Type | Individual |
| Full Name | MEGAN STARK |
| Credential | NP |
| Practice Address |
2805 Campus Dr Ste 235 Plymouth MN 55441-2678 |
| Mailing Address |
1531 N Birch Lake Blvd White Bear Lake MN 55110-6711 |
| Practice Telephone | 9524018300 |
| Mailing Telephone | 6513434768 |
| Enumeration Date | 2015-12-07 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
5527 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 100 East St Se Ste 301, Vienna, VA 221804800 | 7039385555 | 7033198580 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083983787 | Megan Frances Stark | Speech-Language Pathologist | 637 County Route 1, Fort Covington, NY 12937-2807 | 2011-12-26 |
| Street Address |
2805 CAMPUS DR STE 235 |
| City | PLYMOUTH |
| State | MN |
| Zip Code | 55441-2678 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689190019 | The Recovery Clinic LLC | Clinic/Center | 9800 Shelard Pkwy Ste 215, Plymouth, MN 55441 | 2017-08-17 |
| 1356887186 | Katherine Marlow Bell | Dentist | 2805 Campus Dr Ste 245, Plymouth, MN 55441 | 2017-01-18 |
| 1083069538 | Mercade Waldon | Home Health Aide | 3501 Xenium Lane, Plymouth, MN 55441 | 2016-05-03 |
| 1346645538 | Phs Westhealth, Inc | Skilled Nursing Facility | 2775 Campus Drive North, Plymouth, MN 55441 | 2014-10-30 |
| 1427453125 | Samuel David Fine | Pharmacist | 4070 Goldenrod Ln, Plymouth, MN 55441 | 2014-10-24 |
| 1548672538 | Scott Aaron Schmidt | Dentist | 2720 Annapolis Circle N, Suite A, Plymouth, MN 55441 | 2014-05-23 |
| 1831498633 | Comforide Transportation Services LLC | Non-emergency Medical Transport (VAN) | 9730 37th Pl N Suite 201, Plymouth, MN 55441 | 2011-03-18 |
| 1255669271 | Tammy Kae Mehlhaus | Physician Assistant | 2855 Campus Drive, Suite 570, Plymouth, MN 55441 | 2009-12-02 |
| 1164758199 | Stephen P. Boger, Dds, Pa | Dentist | 2720 Annapolis Circle, Suite A, Plymouth, MN 55441 | 2009-10-27 |
| 1093908360 | Endodontic Professionals Pa Plymouth Endodontics | Dentist | 3401 Hwy 169 N, Plymouth, MN 55441 | 2007-08-21 |
| Find all providers in zip 55441 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982072856 | Kristen Joan Rheaume | Nurse Practitioner | Plymouth Pediatric Associates, 139 Sandwich Street, Plymouth, MA 02360 | 2015-09-09 |
| 1033484647 | Ellie Flannery | Nurse Practitioner | 5046 Everest Ln N, Plymouth, MN 55446-4520 | 2012-03-14 |
| 1508375544 | Amy L Lilly | Nurse Practitioner | 990 W Ann Arbor Trl Ste 210, Plymouth, MI 48170-6202 | 2017-09-21 |
| 1437608965 | Tara Valentine | Nurse Practitioner | 990 W Ann Arbor Trl, Suite 210, Plymouth, MI 48170-6204 | 2016-09-26 |
| 1134591472 | Amy Miklich | Nurse Practitioner | 139 Sandwich St, Plymouth, MA 02360-2449 | 2015-10-27 |
| 1114312071 | Jessica Flutie | Nurse Practitioner | 139 Sandwich St, Plymouth, MA 02360-2449 | 2015-03-30 |
| 1043568827 | Kacie Kiyoko Nakamura Gaudet | Nurse Practitioner | 6 Resnik Rd, Plymouth, MA 02360-4873 | 2012-08-27 |
| 1447566559 | Sondra Raubacher | Nurse Practitioner | 990 W Ann Arbor Trl, Suite 210, Plymouth, MI 48170-6204 | 2010-08-26 |
| 1922334036 | Allison N Goulson | Nurse Practitioner | 2855 Campus Dr, #350, Plymouth, MN 55441-2649 | 2009-10-23 |
| 1457595357 | Nicole Dillon | Nurse Practitioner | 990 W Ann Arbor Trl, Ste 210, Plymouth, MI 48170-6204 | 2009-04-23 |
| Find all providers in PLYMOUTH | ||||
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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.