NORTH MEMORIAL HEALTH CARE (NPI# 1336675560) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336675560 |
| Entity Type | Organization |
| Organization Name | NORTH MEMORIAL HEALTH CARE |
| Other Organization Name | NORTH MEMORIAL HEALTH CLINIC - BLAINE NORTH |
| Practice Address |
11855 Ulysses St Ne #110 Blaine MN 55434-3947 |
| Mailing Address |
3300 Oakdale Ave N Robbinsdale MN 55422-2900 |
| Practice Telephone | 7637854500 |
| Practice Fax Number | 7637858424 |
| Enumeration Date | 2017-05-09 |
| Last Update Date | 2020-09-30 |
| Authorized Official Name | MR. DAN FROMM (VP, CFO) |
| Authorized Official Telephone | 7635814614 |
| Is Organization Subpart | Y |
| Parent Organization Name | NORTH MEMORIAL HEALTH CARE |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| North Memorial Health Clinic - Blaine North | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477934818 | North Memorial Health Care | Clinic/Center | 651 Nicollet Mall Ste 277, Minneapolis, MN 55402-1631 | 2015-06-11 |
| 1619364973 | North Memorial Health Care | Clinic/Center | 965 Prairie Center Dr, Eden Prairie, MN 55344-3671 | 2015-04-23 |
| 1992126155 | North Memorial Health Care | Clinic/Center | 8100 42nd Avenue North, New Hope, MN 55428 | 2013-12-13 |
| 1952732729 | North Memorial Health Care | Clinic/Center | 15450 Highway 7 Ste 100, Minnetonka, MN 55345-3522 | 2013-12-04 |
| 1598001067 | North Memorial Health Care | Clinic/Center | 15535 34th Avenue N., Plymouth, MN 55447 | 2013-01-02 |
| 1548434053 | North Memorial Health Care | Clinic/Center | 5615 Xerxes Ave N, Suite D, Brooklyn Center, MN 55430-2819 | 2008-04-15 |
| 1871715136 | North Memorial Health Care | Social Worker | 3366 Oakdale Ave N Ste 315, Robbinsdale, MN 55422-2967 | 2007-05-03 |
| 1437174810 | North Memorial Health Care | Hospice Care, Community Based | 3500 France Ave N, Suite 101, Robbinsdale, MN 55422-2809 | 2006-07-13 |
| 1558392852 | North Memorial Health Care | Clinic/Center | 9855 Hospital Dr Ste 102b, Maple Grove, MN 55369-5021 | 2006-07-05 |
| 1538195912 | North Memorial Health Care | Ambulance | 4501 68th Ave N, Brooklyn Center, MN 55429-1712 | 2006-06-25 |
| Street Address |
11855 ULYSSES ST NE #110 |
| City | BLAINE |
| State | MN |
| Zip Code | 55434-3947 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003893066 | Stacy L Noyes | Obstetrics & Gynecology | 11855 Ulysses St Ne, Blaine, MN 55434-3947 | 2005-12-29 |
| 1427606896 | David Moga | Physical Therapist | 11855 Ulysses St Ne, Blaine, MN 55434-3947 | 2019-08-29 |
| 1811361603 | Pamela Rhiel | Nurse Practitioner | 11855 Ulysses St Ne, Suite 250, Blaine, MN 55434-3947 | 2015-11-17 |
| 1629405931 | Rachel Sinnen | Physician Assistant | 11855 Ulysses St Ne, Blaine, MN 55434-3947 | 2013-10-01 |
| 1538408943 | North Memorial Health Care | Clinic/Center | 11855 Ulysses St Ne, Blaine, MN 55434-3947 | 2013-02-05 |
| 1942547096 | Blaine Urgency Center, LLC | Clinic/Center | 11855 Ulysses St Ne, Blaine, MN 55434-3947 | 2013-01-09 |
| 1467735407 | Carly L. Mattson | Physical Therapist | 11855 Ulysses St Ne, Ste 20, Blaine, MN 55434-3947 | 2011-09-26 |
| 1538497276 | Lori Jean Treb | Dietitian, Registered | 11855 Ulysses St Ne, Blaine, MN 55434-3947 | 2009-11-18 |
| 1760616031 | Blaine Mn Multi Specialty Asc LLC | Clinic/Center | 11855 Ulysses St Ne, Suite 270, Blaine, MN 55434-3947 | 2009-05-14 |
| 1144462219 | Lakeland Health Services, Inc. | Durable Medical Equipment & Medical Supplies | 11855 Ulysses St Ne, Suite 205 and Suite 210, Blaine, MN 55434-3947 | 2009-04-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023628591 | Rahul Farmah | Optometrist | 680 Hwy 10 Ne, Blaine, MN 55434 | 2020-08-08 |
| 1033770714 | Enduring Home Health Care Corp | Home Health | 10812 Fillmore Street, Blaine, MN 55434 | 2019-06-24 |
| 1932762408 | Vital Agency LLC | In Home Supportive Care | 12864 Fillmore Street Ne, Blaine, MN 55434 | 2019-04-19 |
| 1548751654 | Dustin Adam Kakach | Pharmacist | 600 County Hwy 10, Blaine, MN 55434 | 2018-05-24 |
| 1598253445 | Jacob James Apland | Behavioral Analyst | 12401 Oak Park Blvd Ne Apt 316, Blaine, MN 55434 | 2018-04-26 |
| 1962921924 | Mw Minnetonka Operating LLC | Assisted Living Facility | 1005 Paul Parkway Ne, Blaine, MN 55434 | 2017-09-11 |
| 1922526961 | Blaine Asc, LLC | Clinic/Center | 11225 Ulysses Street Northeast, Blaine, MN 55434 | 2017-08-30 |
| 1629591334 | Minnehaha Transportation Inc | Non-emergency Medical Transport (VAN) | 2507 Walnut St, Roseville, MN 55434 | 2017-07-25 |
| 1629590872 | Alexandra Staum Reif | Pediatrics | 11107 Ulysses Street Ne, Suite 100, Blaine, MN 55434 | 2017-07-10 |
| 1962939546 | Nicolette Gengel | Dentist | 1384 109th Ave Ne Ste 200, Blaine, MN 55434 | 2017-05-15 |
| Find all providers in zip 55434 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184867319 | Pain and Brain Healing Center, LLC | Clinic/Center | 1400 131st Ave Ne, Blaine, MN 55449-4124 | 2009-04-17 |
| 1912364134 | Fairview Health Services | Clinic/Center | 10961 Club West Pkwy, Blaine, MN 55449-5866 | 2016-01-19 |
| 1932405388 | Allina Health System | Clinic/Center | 10705 Town Square Dr Ne Ste 100, Blaine, MN 55449-8185 | 2011-02-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871191403 | Cham Clinic LLC | Clinic/Center | 7362 University Ave Ne Ste 206, Fridley, MN 55432-3151 | 2020-10-15 |
| 1003434622 | Lost Lake Optical Company | Clinic/Center | 5240 Shady Island Cir, Mound, MN 55364-9222 | 2020-07-09 |
| 1811513310 | Prescribed By LLC | Clinic/Center | 701 Washington Ave N Ste 111-321, Minneapolis, MN 55401-2822 | 2020-06-19 |
| 1992320014 | Jtp Professional Service Corporation | Clinic/Center | 2038 Ford Pkwy # 444, Saint Paul, MN 55116-1931 | 2020-06-15 |
| 1689299125 | Altru Health System | Clinic/Center | 1st & Roosevelt, Karlstad, MN 56732 | 2020-06-10 |
| 1831710409 | Webmed LLC | Clinic/Center | 925 E Superior St Ste 113, Duluth, MN 55802-2253 | 2020-05-05 |
| 1073149779 | Functional Chiropractic Rehab, Pllc | Clinic/Center | 1901 Madison Ave Ste 120, Mankato, MN 56001-6267 | 2020-03-14 |
| 1225676067 | Liana Healthcare P.ll.c | Clinic/Center | 8348 Beard Rd, Bloomington, MN 55431-1028 | 2019-12-11 |
| 1245875293 | Fairview Clinics | Clinic/Center | 12912 Farnham Ave N, White Bear Lake, MN 55110-5929 | 2019-11-14 |
| 1275175242 | Hye-kyong Kim Therapy LLC | Clinic/Center | 1145 Grand Ave # 101, Saint Paul, MN 55105-2629 | 2019-10-11 |
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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.