ISD 763 MEDFORD PUBLIC SCHOOL (NPI# 1245397603) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245397603 |
| Entity Type | Organization |
| Organization Name | ISD 763 MEDFORD PUBLIC SCHOOL |
| Practice Address |
750 2nd Ave Se Medford MN 55049-9586 |
| Practice Telephone | 5074515250 |
| Practice Fax Number | 5074516474 |
| Mailing Telephone | 5074515250 |
| Mailing Fax Number | 5074516474 |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2008-08-07 |
| Authorized Official Name | GARY BRAUN (SPECIAL EDUCATION COORDINATOR) |
| Authorized Official Telephone | 5074515250 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251300000X | Local Education Agency (LEA) | MN | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 901405500 | 05 |
| Street Address |
750 2ND AVE SE |
| City | MEDFORD |
| State | MN |
| Zip Code | 55049-9586 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295207215 | Joseph J Claeys | Social Worker | 750 2nd Ave Se, Medford, MN 55049-9586 | 2019-01-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184705634 | Our Homes South, Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 113 North Main Street, Medford, MN 55049-0119 | 2006-10-18 |
| 1093969107 | Renae Dawn Blome | Dental Hygienist | 4366 270th St E, Medford, MN 55049-8001 | 2008-11-17 |
| 1124685870 | Tracy L Sunde | Counselor | 512 4th St Sw, Medford, MN 55049-9568 | 2019-05-28 |
| 1598323453 | Refine Service Coordination Pllc | Counselor | 512 4th St Sw, Medford, MN 55049-9568 | 2019-06-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174124226 | Shane William Macdonald | Social Worker | 20 Stearns Ave, Medford, MA 02155-5620 | 2020-11-05 |
| 1386245934 | Stephen Choi | Pharmacist | 12 Blakely Rd, Medford, MA 02155-2409 | 2020-11-02 |
| 1235739277 | Total Body Knowledge | Dietitian, Registered | 2314 Hempstead St Apt 3, Medford, OR 97501-0259 | 2020-10-29 |
| 1366042418 | Sarah Hassan | Registered Nurse | 298 Fellsway W, Medford, MA 02155-2646 | 2020-10-28 |
| 1720688021 | Edward Cutler | Phlebology | 724 S Central Ave Ste 206, Medford, OR 97501-7833 | 2020-10-27 |
| 1801496310 | Dyshonia Louise Dent | Licensed Practical Nurse | 1102 Lake Dr, Medford, NY 11763-4620 | 2020-10-26 |
| 1922607464 | Rogue Therapy | Community/Behavioral Health | 328 S Central Ave Ste 213, Medford, OR 97501-7274 | 2020-10-24 |
| 1295334118 | Moriah J Spendolini | Behavioral Analyst | 3709 Citation Way, Medford, OR 97504-9022 | 2020-10-21 |
| 1245839372 | Giovanni Germain | Behavior Technician | 29 Fells Avenue Ter, Medford, MA 02155-1913 | 2020-10-20 |
| 1821696261 | Julia Elizabeth Erskine | Student in an Organized Health Care Education/Training Program | 119 Boston Ave Apt 1, Medford, MA 02155-3570 | 2020-10-16 |
| Find all providers in MEDFORD | ||||
| Taxonomy Code | 251300000X |
| Grouping | Agencies |
| Classification | Local Education Agency (LEA) |
| The term local education agency means a public board of education or other public authority legally constituted within a State to either provide administrative control or direction of, or perform a service function for public schools serving individuals ages 0 - 21 in a state, city, county, township, school district, or other political subdivision including a combination of school districts or counties recognized in a State as an administrative agency for its public schools. An LEA may provide, or employ professional who provide, services to children included in the Individuals with Disabilities Education Act (IDEA), such services may include, but are not limited to, such medical services as physical, occupational, and speech therapy. |
| Notes: Source: Portions of IDEA Regulations Part B (34 CFR Part 300.18, Assistance to States for the Education of Children with Disabilities) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568831352 | Medford Township Public School | Local Education Agency (LEA) | 137 Hartford Rd, Medford, NJ 08055-9516 | 2015-09-22 |
| 1770735169 | Douglas Education Service District | Local Education Agency (LEA) | 691 Murphy Road, Suite 112, Medical Arts Building, Medford, OR 97504 | 2008-10-16 |
| 1366621971 | Medford School District | Local Education Agency (LEA) | 124 W State St, Medford, WI 54451-1760 | 2007-10-31 |
| 1790815330 | City of Medford | Local Education Agency (LEA) | 489 Winthrop St, Medford, MA 02155-2349 | 2007-03-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649870056 | Great Oaks Academy | Local Education Agency (LEA) | 6300 212th St W, Farmington, MN 55024-8903 | 2020-10-27 |
| 1417562117 | The Journeys School Inc | Local Education Agency (LEA) | 775 Lexington Pkwy N, Saint Paul, MN 55104-1436 | 2020-09-10 |
| 1891303145 | Skyline Math and Science Academy | Local Education Agency (LEA) | 2600 26th Ave S Ste 100, Minneapolis, MN 55406-4527 | 2020-07-22 |
| 1447878210 | Minnesota Internship Center | Local Education Agency (LEA) | 511 Groveland Ave, Minneapolis, MN 55403-3223 | 2020-07-08 |
| 1902443286 | Modern Montessori Charter School | Local Education Agency (LEA) | 111 Dean Ave W, Champlin, MN 55316-1343 | 2019-12-05 |
| 1235601121 | St Croix River Education District | Local Education Agency (LEA) | 425 South Dana Ave, Rush City, MN 55069 | 2018-12-18 |
| 1174094601 | Gateway Stem Academy | Local Education Agency (LEA) | 12119 16th Ave S, Burnsville, MN 55337-2982 | 2018-12-10 |
| 1396210761 | Phoenix Academy of Art and Science | Local Education Agency (LEA) | 38460 Lincoln Trl Ste 1, North Branch, MN 55056-5834 | 2018-10-11 |
| 1538649421 | Career Pathways | Local Education Agency (LEA) | 1355 Pierce Butler Rte, Saint Paul, MN 55104-1359 | 2018-08-20 |
| 1316452436 | Universal Academy Charter School | Local Education Agency (LEA) | 2919 26th Ave S, Minneapolis, MN 55406-2611 | 2017-12-12 |
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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.