EDWARD B MARTIN - CHAFEE (NPI# 1295728848) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295728848 |
| Entity Type | Individual |
| Full Name | EDWARD B MARTIN - CHAFEE |
| Credential | MD |
| Practice Address |
1200 Sixth Ave N St Cloud MN 56303-2735 |
| Practice Telephone | 3202512700 |
| Practice Fax Number | 3202402118 |
| Mailing Telephone | 3202512700 |
| Mailing Fax Number | 3202402118 |
| Enumeration Date | 2005-08-30 |
| Last Update Date | 2015-03-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2080N0001X |
Pediatrics Specialization: Neonatal-Perinatal Medicine |
34891 | MN | Allopathic & Osteopathic Physicians |
| Y | 2080P0202X |
Pediatrics Specialization: Pediatric Cardiology |
34891 | MN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 074563400 | 05 | |
| PREFERRED ONE | 1012096 | 01 | |
| RR MEDICARE | 370015977 | 01 | |
| MEDICA HEALTH PLANS | 4700063P | 01 | |
| FIRST HEALTH PLAN | 690476 | 01 | |
| RR MEDICARE | CQ2388 | 01 | |
| MEDICAL ASSISTANCE (MA) | 074563400 | 01 | |
| ARAZ GROUP/AMERICA'S PPO | 90051 | 01 | |
| HEALTH PARTNERS | HP20318 | 01 | |
| MEDICA HEALTH PLANS | 1207854 | 01 | |
| BLUE CROSS BLUE SHIELD | 51G94MA | 01 | |
| U-CARE | 115598 | 01 |
| Street Address |
1200 SIXTH AVE N |
| City | ST CLOUD |
| State | MN |
| Zip Code | 56303-2735 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306848122 | Bernard Rudolph Erickson | Internal Medicine | 1200 Sixth Ave N, Centracare Clinic, St Cloud, MN 56303-2735 | 2005-08-11 |
| 1255796918 | Tiffany Nicole Sande | Nurse Practitioner | 1200 Sixth Ave N, St Cloud, MN 56303-2735 | 2015-12-23 |
| 1417327651 | Larae A. Lymer | Nurse Practitioner | 1200 Sixth Ave N, St Cloud, MN 56303-2735 | 2015-09-30 |
| 1154799781 | Sarah Catherine Babst | Nurse Practitioner | 1200 Sixth Ave N, St Cloud, MN 56303-2735 | 2015-09-14 |
| 1376933366 | Milissa Sue Mcduffee | Nurse Practitioner | 1200 Sixth Ave N, Centracare Clinic River Campus/heart & Vascular Center, St Cloud, MN 56303-2735 | 2015-01-28 |
| 1174911127 | Kristin Ann Gjerset | Nurse Practitioner | 1200 Sixth Ave N, Centracare Clinic, St Cloud, MN 56303-2735 | 2014-12-29 |
| 1306253323 | Karen Rae Gozel | Clinical Nurse Specialist | 1200 Sixth Ave N, St Cloud, MN 56303-2735 | 2014-07-22 |
| 1093120131 | Courtney Lynn Brever | Physician Assistant | 1200 Sixth Ave N, St Cloud, MN 56303-2735 | 2014-06-27 |
| 1104230879 | Alyssa Marie Monson | Dietitian, Registered | 1200 Sixth Ave N, Centracare Clinic, St Cloud, MN 56303-2735 | 2014-06-20 |
| 1780023846 | Patrick Wayne Odens | Internal Medicine | 1200 Sixth Ave N, St Cloud, MN 56303-2735 | 2013-06-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841800463 | Daniel P Lahr | Radiologic Technologist | St Cloud Va Health Care System, 4801 Veterans Drive, St Cloud, MN 56303 | 2020-08-07 |
| 1730798398 | County of Stearns | Case Management | 705 Courthouse Square, St Cloud, MN 56303 | 2020-07-29 |
| 1669007126 | Aflah Transportation LLC | Non-emergency Medical Transport (VAN) | 3316 3rd Street North, Suite 129, Saint Cloud, MN 56303 | 2020-03-05 |
| 1609420942 | Stephanie Lynne Metzger | Nurse Practitioner | Centracare Clinic Riverc Ampus/nephrology, 1200 Sixth Ave North, St. Cloud, MN 56303 | 2019-07-25 |
| 1306406947 | Willow Tree Acupuncture LLC | Acupuncturist | 203 Cooper Ave N Suite 160, St. Cloud, MN 56303 | 2019-06-17 |
| 1821553520 | Alan Melvin Hoeper | Nurse Anesthetist, Certified Registered | Centracare Clinic Anesthesiology, 3701 12th St N, Suite 202, St. Cloud, MN 56303 | 2019-02-06 |
| 1437644465 | Brianna Larissa Justin | Speech-Language Pathologist | St. Cloud Hospital, 1406 6th Avenue N, St. Cloud, MN 56303 | 2018-06-22 |
| 1780186486 | Simplicity Health Pa | Family Medicine | 1511 Northway Dr Ste 103, Saint Cloud, MN 56303 | 2018-03-08 |
| 1639682925 | Dereje Beyene | Respiratory Therapist, Certified | 1406 15th Street North, Saint Cloud, MN 56303 | 2017-11-09 |
| 1740792761 | Lisa Ann Horner | Nurse Practitioner | 1555 Northway Drive #110, Centracare Complex Care Clinic, St Cloud, MN 56303 | 2017-10-31 |
| Find all providers in zip 56303 | ||||
| Taxonomy Code | 2080P0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Cardiology |
| A pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649723511 | Ryan Greene | Pediatrics | 2450 Riverside Ave Bldg M663, Minneapolis, MN 55454-1450 | 2016-07-27 |
| 1417264821 | Frederic Murray Stone | Pediatrics | 8420 Westmoreland Ln, St Louis Park, MN 55426-1929 | 2010-09-07 |
| 1790921385 | Forrest Blanton Bessinger Jr. | Pediatrics | 2155 Rosewood Ln N, Roseville, MN 55113-5324 | 2009-01-02 |
| 1588819221 | Douglas D. Mair | Pediatrics | 1814 Walden Ln Sw, Rochester, MN 55902-0903 | 2008-11-21 |
| 1376713107 | Charles Webster Shepard | Pediatrics | 2530 Chicago Avenue South Suite 500, Minneapolis, MN 55404 | 2008-03-07 |
| 1932392347 | Shashi Raj | Pediatrics | 2525 Chicago Ave Ste 500, Minneapolis, MN 55404-4518 | 2007-08-20 |
| 1346280351 | Barbara Kelly Gleason Han | Pediatrics | 800 E 28th St, Suite H2100, Minneapolis Heart Institute, Minneapolis, MN 55407 | 2006-06-07 |
| 1659859130 | Ezequiel Sagray | Pediatrics | 200 1st St Sw, Rochester, MN 55905 | 2018-08-06 |
| 1659877181 | Massimo Griselli | Pediatrics | University of Minnesota Physicians, 500 Harvard Street Se, Minneapolis, MN 55455-0363 | 2018-04-03 |
| 1427582071 | Carolina Patricia Larmeu | Pediatrics | 200 1st St Sw, Rochester, MN 55905-0001 | 2017-04-19 |
| Find all providers with the same taxonomy | ||||
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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.