NORTH METRO ORTHOTICS AND PROSTHETICS, INC (NPI# 1356589113) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356589113 |
| Entity Type | Organization |
| Organization Name | NORTH METRO ORTHOTICS AND PROSTHETICS, INC |
| Practice Address |
3111 124th Ave Nw Suite 210 Coon Rapids MN 55433-4572 |
| Mailing Address |
8290 University Ave Ne Suite 310 Fridley MN 55432-1847 |
| Practice Telephone | 7633236921 |
| Practice Fax Number | 7633236940 |
| Mailing Telephone | 7637846647 |
| Mailing Fax Number | 7637847747 |
| Enumeration Date | 2009-01-30 |
| Last Update Date | 2014-01-28 |
| Authorized Official Name | JESSICA DEHAVEN (CORPORATE SECRETARY) |
| Authorized Official Telephone | 7637846647 |
| Is Organization Subpart | Y |
| Parent Organization Name | NORTH METRO ORTHOTICS AND PROSTHETICS, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335E00000X | Prosthetic/Orthotic Supplier | Suppliers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467916791 | North Metro Orthotics and Prosthetics, Inc | Prosthetic/Orthotic Supplier | 10 Central Ave, Osseo, MN 55369-1241 | 2019-01-31 |
| Street Address |
3111 124TH AVE NW SUITE 210 |
| City | COON RAPIDS |
| State | MN |
| Zip Code | 55433-4572 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619926912 | John A Gergen | Physical Therapist | 3111 124th Ave Nw, Suite 100, Coon Rapids, MN 55433-4572 | 2006-05-06 |
| 1396217006 | Darla Lynn Johnson | Occupational Therapist | 3111 124th Ave Nw, Coon Rapids, MN 55433-4572 | 2018-12-19 |
| 1316427933 | Kelsey Mary Ann Loch | Speech-Language Pathologist | 3111 124th Ave Nw, Coon Rapids, MN 55433-4572 | 2018-08-14 |
| 1821577511 | Sara Carroll | Speech-Language Pathologist | 3111 124th Ave Nw, Coon Rapids, MN 55433-4572 | 2018-08-13 |
| 1518453687 | Mary Kay Lundt | Speech-Language Pathologist | 3111 124th Ave Nw, Coon Rapids, MN 55433-4572 | 2018-07-02 |
| 1841785086 | Carrie Johnson | Physical Therapist | 3111 124th Ave Nw, Coon Rapids, MN 55433-4572 | 2018-06-29 |
| 1801262944 | Sarah M Leathers | Physical Therapist | 3111 124th Ave Nw, Suite 123, Coon Rapids, MN 55433-4572 | 2015-08-12 |
| 1538542998 | Kiah Brown | Occupational Therapist | 3111 124th Ave Nw, Coon Rapids, MN 55433-4572 | 2015-07-02 |
| 1720468697 | Ashley Marie Rundle | Physical Therapist | 3111 124th Ave Nw, Suite 200, Coon Rapids, MN 55433-4572 | 2015-06-04 |
| 1356738892 | Emily Eull | Specialist/Technologist | 3111 124th Ave Nw, Coon Rapids, MN 55433-4572 | 2015-04-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770134793 | Shelley Karee Peterson | Technician | 10311 Bittersweet St Nw, Coon Rapids, MN 55433 | 2019-09-20 |
| 1578122057 | Courtney Gau | Behavior Technician | Fraser Coon Rapids, 9120 Springbrook Dr. Nw, Coon Rapids, MN 55433 | 2019-06-10 |
| 1992275606 | Maliki Fofee Kamara | Licensed Practical Nurse | 2451 109th Ave Nw Apt. 1, Coon Rapids, MN 55433 | 2018-11-26 |
| 1992284541 | Sarah Vennes | Massage Therapist | 6400 Flying Cloud Dr, Suite 240, Eden Prairie, MN 55433 | 2018-08-13 |
| 1538646609 | Paige Prince | Behavior Technician | Fraser Coon Rapids, 9120 Springbrook Drive Nw, Coon Rapids, MN 55433 | 2018-07-23 |
| 1154828242 | Karin Lea Englund | Dentist | 9145 Springbrook Dr Nw Ste 100, Coon Rapids, MN 55433 | 2018-04-06 |
| 1235642513 | Vista Family Eye Care LLC | Optometrist | 9920 Foley Blvd Nw Ste 120, Coon Rapids, MN 55433 | 2017-11-09 |
| 1538697818 | Mohammed Nmn Ahmed | Internal Medicine | 9055 Spring Brook Drive, Allina Coon Rapids Clinic 9055, Coon Rapids, MN 55433 | 2017-05-31 |
| 1639531353 | Journi LLC | Nurse Practitioner | 277 Coon Rapids Blvd Suite 308, Coon Rapids, MN 55433 | 2016-03-22 |
| 1821457722 | Honorine Boyce | Licensed Practical Nurse | 2743 111th Ave. Nw, Coon Rapids, MN 55433 | 2016-02-19 |
| Find all providers in zip 55433 | ||||
| Taxonomy Code | 335E00000X |
| Grouping | Suppliers |
| Classification | Prosthetic/Orthotic Supplier |
| An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition. |
| Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538247416 | The Winkley Company | Prosthetic/Orthotic Supplier | 3960 Coon Rapids Blvd, Suite 116, Coon Rapids, MN 55433-2569 | 2006-11-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619578648 | Kanika Lanese Baker | Prosthetic/Orthotic Supplier | 7240 Brooklyn Blvd Ste 150, Brooklyn Park, MN 55429-1274 | 2020-11-05 |
| 1932758067 | David Allen Young | Prosthetic/Orthotic Supplier | 1163 Wayzata Blvd E, Wayzata, MN 55391-1935 | 2019-09-11 |
| 1073080230 | Rebound Orthotics & Prosthetics, Inc. | Prosthetic/Orthotic Supplier | 2805 Campus Dr Ste 101, Plymouth, MN 55441-2676 | 2018-10-25 |
| 1760998165 | Abilitech Medical, Inc. | Prosthetic/Orthotic Supplier | 628 Pine St, Saint Paul, MN 55130-4421 | 2017-12-20 |
| 1003351990 | Arise Orthotics & Prosthetics, Inc. | Prosthetic/Orthotic Supplier | 8338 Highway 65 Ne, Suite E, Spring Lake Park, MN 55432-1364 | 2016-12-30 |
| 1073065298 | Language of Hair | Prosthetic/Orthotic Supplier | 1615 London Rd, Duluth, MN 55812-1620 | 2016-11-04 |
| 1275900664 | Nordstrom Inc & Subsidiaries | Prosthetic/Orthotic Supplier | 12401 Wayzata Blvd, Minnetonka, MN 55305-1974 | 2015-09-01 |
| 1326483264 | Prosthetic Specialties LLC | Prosthetic/Orthotic Supplier | 13143 Lake Place Rd, Zimmerman, MN 55398-9567 | 2013-05-06 |
| 1427300706 | Rebound Orthotics & Prosthetics, Inc. | Prosthetic/Orthotic Supplier | 1073 Highway 15 S, Plaza 15, Hutchinson, MN 55350-3153 | 2012-10-10 |
| 1033461322 | Rebound Orthotics & Prosthetics, Inc. | Prosthetic/Orthotic Supplier | 300 Catlin St Ste 104, Buffalo, MN 55313-2035 | 2012-10-10 |
| Find all providers with the same taxonomy | ||||
| City | COON RAPIDS |
| Zip Code | 55433 |
Please comment or provide details below to improve the information on NORTH METRO ORTHOTICS AND PROSTHETICS, INC.
| 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.