ALBERTVILLE - ST. MICHAEL CLINIC (NPI# 1285804336) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285804336 |
| Entity Type | Organization |
| Organization Name | ALBERTVILLE - ST. MICHAEL CLINIC |
| Practice Address |
11091 Jason Ave Ne Albertville MN 55301-4699 |
| Mailing Address |
5626 Oberlin Dr Suite 110 San Diego CA 92121-1705 |
| Practice Telephone | 7636848300 |
| Enumeration Date | 2008-03-05 |
| Last Update Date | 2015-07-14 |
| Authorized Official Name | KENNY HEINE (VP OF OPERATIONS) |
| Authorized Official Telephone | 8586252990 |
| Is Organization Subpart | Y |
| Parent Organization Name | MEDVANTX, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332900000X | Non-Pharmacy Dispensing Site | 53129 | MN | Suppliers |
| Street Address |
11091 JASON AVE NE |
| City | ALBERTVILLE |
| State | MN |
| Zip Code | 55301-4699 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881614766 | Jeffrey T Kvant | Physician Assistant | 11091 Jason Ave Ne, Albertville, MN 55301-4699 | 2006-07-20 |
| 1144764150 | Alexis Hydukovich | Physical Therapist | 11091 Jason Ave Ne, Suite 2, Albertville, MN 55301-4699 | 2016-12-09 |
| 1417316936 | Heather Lynn Pokrzywinski | Physician Assistant | 11091 Jason Ave Ne, Albertville, MN 55301-4699 | 2016-02-11 |
| 1366826752 | Pdg, Pa | Clinic/Center | 11091 Jason Ave Ne, Suite 3, Albertville, MN 55301-4699 | 2015-07-15 |
| 1437392586 | Megan Tiffany Otis | Family Medicine | 11091 Jason Ave Ne, Albertville, MN 55301-4699 | 2009-04-18 |
| 1235311853 | Now Care Medical Centers | Clinic/Center | 11091 Jason Ave Ne, Albertville, MN 55301 | 2007-12-05 |
| 1366639593 | Nathania Kathleen Hammel | Family Medicine | 11091 Jason Ave Ne, Albertville, MN 55301-4699 | 2007-10-02 |
| 1205022845 | Stellis Health, Pa | Clinic/Center | 11091 Jason Ave Ne, Albertville, MN 55301 | 2007-09-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780127373 | Shanda Gwen Gaunt | Speech-Language Pathologist | 11091 Jasen Ave Ne Suite 2, Courage Kenny Rehabilitation Institute Albertville Part, Albertville, MN 55301 | 2016-11-30 |
| 1124478110 | Chiropractic and Wellness Center of Albertville | Chiropractor | 5676 Lacentre Ave., Suite 204, Albertville, MN 55301 | 2016-06-21 |
| 1184073157 | Keith Henry Diers | Physical Therapist | 11091 Jason Ave Nw, Suite 2, Albertville, MN 55301 | 2016-06-09 |
| 1154613479 | Francis Ogeto Raini | Nurse Practitioner | 7046 Lambert Lane Ne, Albertville, MN 55301 | 2011-05-04 |
| 1770802019 | Chiropractic and Wellness Center of Albertville Pllc | Chiropractor | 5676 Lacentre Avenue Ne, Suite 202, Albertville, MN 55301 | 2010-05-26 |
| 1508054339 | Andrea Lynn Anderson | Pharmacist | 5698 Lacentre Ave Ne, Albertville, MN 55301 | 2007-10-05 |
| 1902080518 | Heidi Sawdey | Chiropractor | 5676 Lacentre Avenue, Albertville, MN 55301-0000 | 2007-12-19 |
| 1275863508 | Lori Hunt | Community Health Worker | 10482 64th Way, Albertville, MN 55301-3517 | 2010-01-08 |
| 1194984070 | Brian Carl Peterson | Physical Therapy Assistant | 10439 64th Ln Ne, Albertville, MN 55301-3533 | 2008-06-05 |
| 1639241300 | Coborns Inc | Durable Medical Equipment & Medical Supplies | 5698 La Centre Ave, Albertville, MN 55301-3972 | 2006-11-15 |
| Find all providers in zip 55301 | ||||
| Taxonomy Code | 332900000X |
| Grouping | Suppliers |
| Classification | Non-Pharmacy Dispensing Site |
| A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518528397 | Fairview Pharmacy Services LLC | Non-Pharmacy Dispensing Site | Fairview Lakeville Clinic Mtm, 18580 Joplin Ave, Lakeville, MN 55044 | 2019-06-24 |
| 1851856504 | Tareen Dermatology, Pa | Non-Pharmacy Dispensing Site | 2945 Hazelwood St Ste 230, Maplewood, MN 55109-1241 | 2019-02-07 |
| 1417450651 | Cerner Health Connections, Inc | Non-Pharmacy Dispensing Site | 4001 Lexington Ave N Ste C2-435, Arden Hills, MN 55126-2934 | 2018-03-14 |
| 1316461593 | Fairview Pharmacy Service LLC | Non-Pharmacy Dispensing Site | 7250 France Ave S Ste 410, Edina, MN 55435-4314 | 2017-07-31 |
| 1346653052 | Advanced Spine and Pain Clinics of Mn, LLC | Non-Pharmacy Dispensing Site | 308 Brighton Ave, Suite D, Buffalo, MN 55313-2303 | 2014-06-10 |
| 1407296148 | Group Health Plan Inc | Non-Pharmacy Dispensing Site | 1833 2nd Ave, Anoka, MN 55303-2432 | 2013-06-26 |
| 1295178135 | Fairview Pharmacy Services LLC | Non-Pharmacy Dispensing Site | 6440 Nicollet Ave South, Richfield, MN 55423-1613 | 2013-04-10 |
| 1992148845 | Fairview Pharmacy Services LLC | Non-Pharmacy Dispensing Site | 2450 Riverside Ave South, Minneapolis, MN 55454-1400 | 2013-04-10 |
| 1083984876 | Mayo Clinic Health System-southeast Minnesota Region | Non-Pharmacy Dispensing Site | 32021 County 24 Boulevard, Cannon Falls, MN 55009-1824 | 2012-01-10 |
| 1255623765 | Mankato Clinic, Ltd | Non-Pharmacy Dispensing Site | 305 Main St Ne, Mapleton, MN 56065 | 2011-05-03 |
| Find all providers with the same taxonomy | ||||
| City | ALBERTVILLE |
| Zip Code | 55301 |
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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.