PARK NICOLLET (NPI# 1265840888) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265840888 |
| Entity Type | Organization |
| Organization Name | PARK NICOLLET |
| Practice Address |
15111 Twelve Oaks Center Dr Minnetonka MN 55305-5201 |
| Mailing Address |
4401 Park Glen Rd St Louis Park MN 55416-4700 |
| Practice Telephone | 9529935900 |
| Enumeration Date | 2014-07-28 |
| Last Update Date | 2014-07-28 |
| Authorized Official Name | DEBBI BENSON (PNHS CREDENTIALING SERVICES) |
| Authorized Official Telephone | 9529935911 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982150728 | Park Nicollet | Clinic/Center | 9555 Upland Ln N, Maple Grove, MN 66369 | 2016-08-31 |
| 1174975528 | Park Nicollet | Clinic/Center | 9555 Upland Ln N, Maple Grove, MN 55369-4485 | 2016-07-11 |
| 1053623785 | Park Nicollet | Clinic/Center | 8455 Flying Cloud Dr, Eden Prairie, MN 55344-3974 | 2010-07-10 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | PARK NICOLLET CLINIC | 3800 Pk Nicollet Blvd, Minneapolis, MN 55416-2527 |
| Oklahoma Business Registrations | PARK NICOLLET MEDICAL FOUNDATION | 5000 W 39th. St., St Louis Park, MN 55416 |
| System for Award Management (SAM) Entities | PARK NICOLLET METHODIST HOSPITAL | 6500 Excelsior Blvd, Saint Louis Park, MN 55426-4702 |
| Street Address |
15111 TWELVE OAKS CENTER DR |
| City | MINNETONKA |
| State | MN |
| Zip Code | 55305-5201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558344176 | Benjamin Pease IIi | Internal Medicine | 15111 Twelve Oaks Center Dr, Minnetonka, MN 55305-5201 | 2005-11-29 |
| 1932764313 | Mollie Naughton | Nurse Practitioner | 15111 Twelve Oaks Center Dr, Minnetonka, MN 55305-5201 | 2019-05-01 |
| 1235636275 | Anna Theis | Physical Therapist | 15111 Twelve Oaks Center Dr, Minnetonka, MN 55305-5201 | 2018-04-06 |
| 1972036531 | Jennifer Renee Signor | Pediatrics | 15111 Twelve Oaks Center Dr, Minnetonka, MN 55305-5202 | 2017-04-10 |
| 1780133314 | Ariel Brea- Anna Cole | Physical Therapist | 15111 Twelve Oaks Center Dr, Minnetonka, MN 55305-5201 | 2016-09-23 |
| 1821476862 | Lisa Vigen | Physical Therapist | 15111 Twelve Oaks Center Dr, Minnetonka, MN 55305-5201 | 2015-05-11 |
| 1699174250 | Park Nicollet Health Services | Clinic/Center | 15111 Twelve Oaks Center Dr, Minnetonka, MN 55305-5201 | 2014-08-20 |
| 1326447921 | Christine Delahunt | Physical Therapist | 15111 Twelve Oaks Center Dr, Minnetonka, MN 55305 | 2014-08-19 |
| 1568872547 | Laura Hanson | Obstetrics & Gynecology | 15111 Twelve Oaks Center Dr, Minnetonka, MN 55305-5202 | 2014-04-30 |
| 1669892170 | Laura Conger | Student in an Organized Health Care Education/Training Program | 15111 Twelve Oaks Center Dr, Minnetonka, MN 55305-5201 | 2014-04-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255948584 | Sober Living Connection | Substance Abuse Rehabilitation Facility | 11115 Minnetonka Blvd, Hopkins, MN 55305 | 2020-09-30 |
| 1649739103 | Gabriel Douglas Orem | Occupational Therapist | 10653 Waysata Blvd., Suite 200, Minnetonka, MN 55305 | 2019-03-14 |
| 1750863106 | Andrea Haglin | Counselor | 10505 Wayzata Blvd. Ste 101, Minnetonka, MN 55305 | 2018-09-02 |
| 1770934499 | Acme Transportation | Private Vehicle | 11356 Cedar Pointe Dr, Minnetonka, MN 55305 | 2016-06-23 |
| 1841641743 | Laine Cecily Hartwell Epp | Counselor | 1300 Wayzata Blvd., Ste. 400, Minnetonka, MN 55305 | 2016-06-22 |
| 1407217367 | Larissa Vados | Acupuncturist | 11654 Wayzata Blvd, Minnetonka, MN 55305 | 2016-03-18 |
| 1548658982 | Irene Grudsky | Contractor | 10550 Wayzata Blvd, Minnetonka, MN 55305 | 2015-01-08 |
| 1780093500 | Lalaine Arbuthnot Ortlieb | Counselor | 11900 Wayzata Blvd, Suite 100, Minnetonka, MN 55305 | 2014-08-06 |
| 1235472275 | Katherine Thistle Rivard | Dietitian, Registered | 11240 Cedar Pointe Drive North, Minnetonka, MN 55305 | 2013-03-28 |
| 1558633784 | Vickie Lynn Schaefer | Social Worker | 10505 Wayzata Blve Suite 101, Minnetonka, MN 55305 | 2012-02-03 |
| Find all providers in zip 55305 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780629857 | Arc Minnetonka, LLC | Clinic/Center | 500 Carlson Pkwy, Minnetonka, MN 55305-5304 | 2006-06-20 |
| 1861948739 | Reneu Physical Therapy LLC | Clinic/Center | 12993 Ridgedale Dr Ste 103, Minnetonka, MN 55305-1804 | 2016-08-30 |
| 1699174250 | Park Nicollet Health Services | Clinic/Center | 15111 Twelve Oaks Center Dr, Minnetonka, MN 55305-5201 | 2014-08-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932716669 | C.o.m.p.e.t.e Physical Therapy & Wellness LLC | Clinic/Center | 1517 Johnson Dr, Moorhead, MN 56560-7441 | 2020-09-27 |
| 1043846173 | Persistence Physical Therapy LLC | Clinic/Center | 2009 W Broadway Ave, Ste 400 Pmb 131, Forest Lake, MN 55025 | 2020-03-20 |
| 1700419207 | Emily L Parnell | Clinic/Center | 983 James Ave, Saint Paul, MN 55102-3330 | 2020-02-13 |
| 1447898358 | Joy Physical Therapy Inc. | Clinic/Center | 1648 River Bluff Ct, Eagan, MN 55121-1719 | 2019-12-11 |
| 1578125159 | Evolve Rehab & Performance LLC | Clinic/Center | 4346 Wooddale Ave, St Louis Park, MN 55424-1061 | 2019-07-03 |
| 1093375198 | Taylor Doeden | Clinic/Center | 1929 33rd St S, Moorhead, MN 56560-3951 | 2019-06-19 |
| 1083176101 | Transcend Rehab & Wellness LLC | Clinic/Center | 1227 17th St Sw, Willmar, MN 56201-2843 | 2019-04-05 |
| 1891250635 | Physiyo, LLC | Clinic/Center | 8646 Eagle Creek Cir Suite 109, Savage, MN 55378-1572 | 2019-02-06 |
| 1922562883 | Kinecio | Clinic/Center | 7650 Currell Blvd Ste 325, Woodbury, MN 55125-2257 | 2019-01-24 |
| 1366916363 | She Pt LLC | Clinic/Center | 5410 Abbott Pl, Edina, MN 55410-2320 | 2019-01-14 |
| Find all providers with the same taxonomy | ||||
| City | MINNETONKA |
| Zip Code | 55305 |
Please comment or provide details below to improve the information on PARK NICOLLET.
| 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.