GILLETTE CHILDREN'S SPECIALTY HEALTHCARE (NPI# 1235639113) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1235639113 |
Entity Type | Organization |
Organization Name | GILLETTE CHILDREN'S SPECIALTY HEALTHCARE |
Other Organization Name | GILLETTE CHILDREN'S SPECIALTY HEALTHCARE MARSHALL CLINIC |
Practice Address |
300 S Bruce St Marshall MN 56258-1934 |
Mailing Address |
200 University Ave E Saint Paul MN 55101-2507 |
Practice Telephone | 6512912848 |
Enumeration Date | 2018-02-16 |
Last Update Date | 2018-02-16 |
Authorized Official Name | LADONNA ROSS (CBO SUPERVISOR) |
Authorized Official Telephone | 6513252139 |
Is Organization Subpart | Y |
Parent Organization Name | GILLETTE CHILDREN'S SPECIALTY HEALTHCARE |
Parent Organization TIN |
|
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities | ||
N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
N | 335E00000X | Prosthetic/Orthotic Supplier | Suppliers | ||
Y | 332BC3200X |
Durable Medical Equipment & Medical Supplies Specialization: Customized Equipment |
Suppliers |
Other Name | Type Code |
---|---|
Gillette Children's Specialty Healthcare Marshall Clinic | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1427557867 | Gillette Children's Specialty Healthcare | Clinic/Center | 505 Paul Bunyan Dr Nw, Bemidji, MN 56601-2400 | 2018-02-11 |
1114267093 | Gillette Children's Specialty Healthcare | Clinic/Center | 12400 Whitewater Dr Ste 2030, Minnetonka, MN 55343-4159 | 2013-02-28 |
1598068819 | Gillette Children's Specialty Healthcare | Durable Medical Equipment & Medical Supplies | 1303 1st St S Ste 1, Willmar, MN 56201-3493 | 2010-12-08 |
1801109012 | Gillette Children's Specialty Healthcare | Prosthetic/Orthotic Supplier | 15860 Audubon Way, Baxter, MN 56401-6943 | 2010-07-16 |
1730363698 | Gillette Children's Specialty Healthcare | Durable Medical Equipment & Medical Supplies | 9550 Upland Lane North, Suite 220, Maple Grove, MN 55369 | 2007-12-27 |
1225119175 | Gillette Children's Specialty Healthcare | Clinic/Center | 200 East University Ave, St. Paul, MN 55101 | 2006-10-18 |
1891319943 | Gillette Children's Specialty Healthcare | Non-Pharmacy Dispensing Site | 200 University Ave E, Saint Paul, MN 55101-2507 | 2020-06-04 |
1528455128 | Gillette Children's Specialty Healthcare | Durable Medical Equipment & Medical Supplies | 1303 1st St S, Suite 1, Willmar, MN 56201-3492 | 2015-04-21 |
1215324983 | Gillette Children's Specialty Healthcare | Durable Medical Equipment & Medical Supplies | 2024 S 6th St, Brainerd, MN 56401-4529 | 2015-04-21 |
1194111724 | Gillette Children's Specialty Healthcare | Durable Medical Equipment & Medical Supplies | 300 S Bruce St, Marshall, MN 56258-1934 | 2015-04-10 |
Entity Type | Entity Name | Entity Address |
---|---|---|
Colorado Business Entities | Gillette Children's Specialty Healthcare | 200 University Avenue East, St. Paul, MN 55101 |
System for Award Management (SAM) Entities | GILLETTE CHILDREN'S SPECIALTY HEALTHCARE | 200 University Ave E, Saint Paul, MN 55101-2507 |
Street Address |
300 S BRUCE ST |
City | MARSHALL |
State | MN |
Zip Code | 56258-1934 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1922003409 | Alain Desy | Orthopaedic Surgery | 300 S Bruce St, Marshall, MN 56258-1934 | 2005-06-20 |
1336750702 | Neil Thomas Eichten | Speech-Language Pathologist | 300 S Bruce St, Marshall, MN 56258-1934 | 2020-08-11 |
1427669894 | Victoria Ann Botten | Speech-Language Pathologist | 300 S Bruce St, Marshall, MN 56258-1934 | 2020-08-11 |
1811506694 | Kendall Drew Hines | Physical Therapist | 300 S Bruce St, Marshall, MN 56258-1934 | 2020-07-28 |
1053934877 | Karen Marie Kersting | Physical Therapist | 300 S Bruce St, Marshall, MN 56258-1934 | 2020-05-27 |
1306474747 | Ramy Vandendriessche | Physical Therapist | 300 S Bruce St, Marshall, MN 56258-1934 | 2020-03-31 |
1114576535 | Analisa Kay Buysse | Pharmacist | 300 S Bruce St, Marshall, MN 56258-1934 | 2019-09-09 |
1346894748 | Jacob Bottelberghe | Physician Assistant | 300 S Bruce St, Marshall, MN 56258-1934 | 2019-07-25 |
1598224321 | Hannah Sue Reski | Physician Assistant | 300 S Bruce St, Marshall, MN 56258-1934 | 2019-03-19 |
1245709443 | Amy Marie Meyeraan-rowe | Nurse Practitioner | 300 S Bruce St, Marshall, MN 56258-1934 | 2018-11-16 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1285140012 | Action Manufacturing Inc | Durable Medical Equipment & Medical Supplies | 1105 Lake Road, Marshall, MN 56258 | 2017-12-15 |
1124579123 | Themarshrx | Durable Medical Equipment & Medical Supplies | 600 Sherman Ave, Marshall, MN 56258 | 2016-10-14 |
1780020370 | Heritage Pointe Senio | Assisted Living Facility | 207 N 4th Street, Marshall, MI 56258 | 2013-05-22 |
1528351178 | Lori Anne Lynner | Family Medicine | 3160 Us Hwy 59, Marshall, MN 56258 | 2011-05-16 |
1912148545 | Tami J Behnke | Counselor | 1418 State Street, Campus Religious Center, Marshall, MN 56258 | 2009-03-11 |
1073768396 | Sharyce Marie Audiology Inc | Audiologist | 1424 East College Drive, Suite 200, Marshall, MN 56258 | 2008-12-01 |
1497976625 | Erica Anne Jost | Specialist/Technologist | 1501 State Street, Marshall, MN 56258 | 2007-05-02 |
1265597470 | Nancy Louise Hemmingson | Optometrist | 300 S Bruce Street, Avera Marshall Southwest Ophthalmology, Marshall, MN 56258 | 2006-12-27 |
1407928187 | Midwest Vision Centers Inc | Technician/Technologist | 1113 E College Drive, Marshall, MN 56258 | 2006-11-15 |
1306918354 | Paul Joseph Puetz | Chiropractor | 111 Jewett St, Marshall, MN 56258 | 2006-11-14 |
Find all providers in zip 56258 |
Taxonomy Code | 332BC3200X |
Grouping | Suppliers |
Classification | Durable Medical Equipment & Medical Supplies |
Specialization | Customized Equipment |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1447276993 | Thermodesigns | Durable Medical Equipment & Medical Supplies | 3908 Bridle Path, Marshall, TX 75672-2404 | 2006-07-15 |
1174584197 | Value Care Inc | Durable Medical Equipment & Medical Supplies | 3160 W Arrow St, Marshall, MO 65340-9689 | 2006-03-29 |
1194111724 | Gillette Children's Specialty Healthcare | Durable Medical Equipment & Medical Supplies | 300 S Bruce St, Marshall, MN 56258-1934 | 2015-04-10 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1053975045 | Erin Michelle Shusta | Durable Medical Equipment & Medical Supplies | 8722 47th St Sw, Howard Lake, MN 55349-5203 | 2019-04-25 |
1538635248 | Baby's On Broadway | Durable Medical Equipment & Medical Supplies | 47 E Broadway, Little Falls, MN 56345-3046 | 2018-10-19 |
1104392398 | Fairview Health Services | Durable Medical Equipment & Medical Supplies | 1875 Woodwinds Dr Ste 150, Woodbury, MN 55125-2518 | 2018-10-16 |
1588167886 | Wes Utility Services Inc | Durable Medical Equipment & Medical Supplies | 1064 140th Ave, Ogilvie, MN 56358-3568 | 2018-03-13 |
1528579869 | Anybattery Inc | Durable Medical Equipment & Medical Supplies | 2605 160th St W Ste 116, Rosemount, MN 55068-1632 | 2017-10-13 |
1801315650 | North Star Podiatric Laboratories Inc. | Durable Medical Equipment & Medical Supplies | 7400 Lyndale Ave S Ste 160, Richfield, MN 55423-4142 | 2017-09-13 |
1053831941 | Chanhassen Family Dentistry Pa | Durable Medical Equipment & Medical Supplies | 8116 Mallory Ct, Chanhassen, MN 55317-8586 | 2017-06-22 |
1972040319 | William Edward Goldberg | Durable Medical Equipment & Medical Supplies | 1254 Robert St S, 1260 South Robert Street, West St Paul, MN 55118-2448 | 2017-01-24 |
1639622814 | Berkshire Construction Company | Durable Medical Equipment & Medical Supplies | 2605 Fernbrook Ln N Ste A, Plymouth, MN 55447-4745 | 2016-07-25 |
1730541830 | Waldoch Crafts, Inc. | Durable Medical Equipment & Medical Supplies | 13821 Lake Dr Ne, Forest Lake, MN 55025-9444 | 2016-03-28 |
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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.