FAIRVIEW NORTHLAND (NPI# 1336209139) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336209139 |
| Entity Type | Organization |
| Organization Name | FAIRVIEW NORTHLAND |
| Practice Address |
911 Northland Dr Princeton MN 55371-2172 |
| Mailing Address |
13854 Riverview Dr Nw Elk River MN 55330-1626 |
| Practice Telephone | 7633896420 |
| Mailing Telephone | 7634410487 |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | SANDRA WHITCOMB (REHAB ASSISTANT) |
| Authorized Official Telephone | 7633896420 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 283X00000X | Rehabilitation Hospital | 4410 | MN | Hospitals |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | FAIRVIEW NORTHLAND REGIONAL HOSPITAL | 911 Northland Dr, Princeton, MN 55371-2172 |
| Street Address |
911 NORTHLAND DR |
| City | PRINCETON |
| State | MN |
| Zip Code | 55371-2172 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922085299 | Fairview Health Services | Pathology | 911 Northland Dr, Princeton, MN 55371-2172 | 2005-12-28 |
| 1912515388 | Fairview Express Care | General Practice | 911 Northland Dr, Princeton, MN 55371-2172 | 2020-07-21 |
| 1780226142 | Paul Moench | Physical Therapist | 911 Northland Dr, Princeton, MN 55371-2172 | 2019-10-17 |
| 1730652512 | Nicole Burrington | Speech-Language Pathologist | 911 Northland Dr, Princeton, MN 55371-2172 | 2019-01-04 |
| 1972015550 | Morgan Taubel | Dietitian, Registered | 911 Northland Dr, Princeton, MN 55371-2172 | 2017-11-03 |
| 1457871956 | Sara Jesse Gleason | Physical Therapist | 911 Northland Dr, Princeton, MN 55371-2172 | 2017-06-26 |
| 1952779266 | Fairview Health Services | Family Medicine | 911 Northland Dr, Princeton, MN 55371-2172 | 2015-09-03 |
| 1376929547 | Dominique Meyer | Nurse Practitioner | 911 Northland Dr, Princeton, MN 55371-2172 | 2015-08-10 |
| 1841673647 | Fairview Health Services | Family Medicine | 911 Northland Dr, Princeton, MN 55371-2172 | 2015-06-30 |
| 1013399112 | Breanna Peterson | Emergency Medicine | 911 Northland Dr, Princeton, MN 55371 | 2015-06-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053962530 | Monica Gail Broten | Technician | 30840 Tiger Street Nw, Princeton, MN 55371 | 2019-09-25 |
| 1215349584 | Stephen Destefano | Pharmacist | 31419 131st Street, Princeton, MN 55371 | 2014-05-21 |
| 1164798948 | Andrew Sudbeck | Counselor | 101 18th Avenue North, Princeton, MN 55371 | 2012-03-27 |
| 1073804803 | Sterling Pointe Senior Living LLC | Assisted Living Facility | 1250 Northland Drive, Princeton, MN 55371 | 2011-04-27 |
| 1568752533 | Rum River Health Services, Inc. | Substance Abuse Rehabilitation Facility | 3079 90th Avenue, Princeton, MN 55371 | 2011-04-12 |
| 1780989038 | Dr. Kynan Westermeyer, Dds, Pllc | Clinic/Center | 404 1st St. N, Princeton, MN 55371 | 2011-01-18 |
| 1275788085 | Cody James Leff | Pharmacist | 1100 11th Avenue South, Princeton, MN 55371 | 2008-11-20 |
| 1164679213 | Rum River Health Services, Inc | Substance Abuse Rehabilitation Facility | 1101 N 5th St, Princeton, MN 55371 | 2008-08-20 |
| 1801059639 | Rum River Health Services, Inc | Substance Abuse Rehabilitation Facility | 1506 1st Street, Princeton, MN 55371 | 2008-07-02 |
| 1497940928 | James Michael Mandt | Pharmacist | 911 Northland Drive, Fairview Northland Medical Center, Princeton, MN 55371 | 2007-09-07 |
| Find all providers in zip 55371 | ||||
| Taxonomy Code | 283X00000X |
| Grouping | Hospitals |
| Classification | Rehabilitation Hospital |
| A hospital or facility that provides health-related, social and/or vocational services to disabled persons to help them attain their maximum functional capacity. |
| Notes: Source: Joint Commission on Accreditation of Healthcare Organizations, Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Oakbrook Terrace, IL: 1994, p. 323 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508839200 | Rehabilitation Hospital Corporation of America LLC | Rehabilitation Hospital | 120 12th Street Ext, Princeton, WV 24740-2352 | 2006-02-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114391307 | Therese Ann Wengler | Rehabilitation Hospital | 1206 Niles Avenue, Saint Paul, MN 55116 | 2015-11-25 |
| 1649653965 | Samantha Hoy | Rehabilitation Hospital | 1467 Lake St S, 300, Forest Lake, MN 55025-4505 | 2015-07-06 |
| 1215272372 | Kimberly A Meegan | Rehabilitation Hospital | 1695 County Road D E Apt 132, Maplewood, MN 55109-5327 | 2012-11-30 |
| 1033403167 | Reflex Staffing | Rehabilitation Hospital | 4574 137th St W, Apple Valley, MN 55124-5211 | 2011-06-07 |
| 1821317116 | Reflex Services | Rehabilitation Hospital | 4574 137 Street West, Apple Valley, MN 55124 | 2010-05-26 |
| 1215130364 | Casey J Byron | Rehabilitation Hospital | 5242 Xerxes Ave S, Minneapolis, MN 55410-2447 | 2007-06-07 |
| 1205929981 | Minnesota Neurorehabilitaion Hospital | Rehabilitation Hospital | 11615 State Ave, Brainerd, MN 56401-7306 | 2006-10-02 |
| 1972055341 | Audra Lynn Taylor | Rehabilitation Hospital | 6401 France Ave S, Edina, MN 55435-2104 | 2016-11-01 |
| 1679959878 | Allina Health | Rehabilitation Hospital | 800 E 28th St, Minneapolis, MN 55407-3723 | 2015-08-11 |
| 1144548322 | University of Minnesota Medical Center, Fairview | Rehabilitation Hospital | 2450 Riverside Ave, Fco-4, Minneapolis, MN 55454-1450 | 2010-05-12 |
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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.