SUMMIT ORTHOPEDICS, LTD (NPI# 1386007417) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386007417 |
| Entity Type | Organization |
| Organization Name | SUMMIT ORTHOPEDICS, LTD |
| Practice Address |
4123 Radio Drive, Ste 100 Woodbury MN 55129 |
| Mailing Address |
710 Commerce Dr Ste 200 Woodbury MN 55125-4925 |
| Practice Telephone | 6519685201 |
| Mailing Telephone | 6519685675 |
| Mailing Fax Number | 6519685904 |
| Enumeration Date | 2016-04-05 |
| Last Update Date | 2018-05-11 |
| Authorized Official Name | JOHN BIEN (CFO) |
| Authorized Official Telephone | 6519685870 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447609664 | Summit Orthopedics, Ltd | Clinic/Center | 2620 Eagan Woods Drive Ste 200, Eagan, MN 55121-1466 | 2016-06-08 |
| 1164870895 | Summit Orthopedics, Ltd | Clinic/Center | 2620 Eagan Woods Drive Ste 300, Eagan, MN 55121-1466 | 2016-06-03 |
| 1841655156 | Summit Orthopedics, Ltd | Physical Medicine & Rehabilitation | 2800 Chicago Ave Ste 402, Minneapolis, MN 55407-1352 | 2015-12-31 |
| 1497120588 | Summit Orthopedics, Ltd | Clinic/Center | 15700 37th Ave N Ste 210, Plymouth, MN 55446-3662 | 2015-12-01 |
| 1306899463 | Summit Orthopedics, Ltd | Physical Therapist | 710 Commerce Dr Ste 200, Woodbury, MN 55125 | 2006-05-18 |
| 1962944827 | Summit Orthopedics, Ltd | Durable Medical Equipment & Medical Supplies | 2620 Eagan Woods Drive Ste 200, Eagan, MN 55121-1466 | 2016-11-09 |
| 1053779215 | Summit Orthopedics, Ltd | Physician Assistant | 15700 37th Ave N Ste 150, Plymouth, MN 55446-3675 | 2016-02-03 |
| 1568843621 | Summit Orthopedics, Ltd | Orthopaedic Surgery | 1400 Corporate Center Curv, Eagan, MN 55121-1373 | 2015-06-15 |
| 1790108140 | Summit Orthopedics, Ltd | Clinic/Center | 3580 Arcade St Ste 250, Vadnais Heights, MN 55127-7135 | 2014-01-21 |
| 1215358346 | Summit Orthopedics, Ltd | Orthopaedic Surgery | 3580 Arcade St, Vadnais Heights, MN 55127-7135 | 2013-12-16 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Summit Orthopedics, Ltd. | 710 Commerce Dr., Suite 200, Woodbury, MN 55125 |
| Street Address |
4123 RADIO DRIVE, STE 100 |
| City | WOODBURY |
| State | MN |
| Zip Code | 55129 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730454752 | Amanda E Feeney | Physical Therapist | 4123 Radio Drive, Ste 100, Woodbury, MN 55129 | 2012-03-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770006983 | Logan Thompson | Chiropractor | 10631 Pond Curve, Woodbury, MN 55129 | 2017-07-19 |
| 1942650619 | The Hendricks Group Inc. | Assisted Living Facility | 10025 Antrim Court, Woodbury, MN 55129 | 2016-06-14 |
| 1235588468 | Nathan Robert Mayernik | Physical Therapist | 4123 Radio Dr, Suite 100, Woodbury, MN 55129 | 2016-06-08 |
| 1699146035 | St. Therese of Woodbury, LLC | Skilled Nursing Facility | 7555 Bailey Road, Woodbury, MN 55129 | 2015-10-12 |
| 1548602865 | Monica Bajracharya | Internal Medicine | 9373 Compass Pointe Rd, Woodbury, MN 55129 | 2013-07-28 |
| 1104193762 | Minneapolis-st.paul Endodontics | Dentist | 10150 City Walk Dr Ste C, Woodbury, MN 55129 | 2011-11-28 |
| 1659502417 | Charles Goff Jr. | Marriage & Family Therapist | 1919 University Ave W Suite 200, St. Paul, MN 55129 | 2009-07-28 |
| 1497821391 | Kyle Riley Edlund | Dentist | 3060 Woodbury Drive, #b, Woodbury, MN 55129 | 2006-11-24 |
| 1902979206 | Robert Edgar Eng | Dentist | 3100 Woodbury Drive, Woodbury, MN 55129 | 2006-11-16 |
| 1629004692 | Therex Rehab Specialists, LLC | Physical Therapist | 1125 Woodbury Drive, Suite 100, Woodbury, MN 55129 | 2006-06-23 |
| Find all providers in zip 55129 | ||||
| Taxonomy Code | 207XX0005X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Sports Medicine |
| An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton changed, source changed] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. ACGME Accredited Program Requirements: 1 year GME in the specialty + 5 years of Orthopaedic Surgery for a total of 6 years |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770642530 | Jeffrey S Sider | Orthopaedic Surgery | 812 Woodbury Rd, Woodbury, NY 11797-2501 | 2006-12-07 |
| 1316101447 | James Michael Paci | Orthopaedic Surgery | 45 Crossways Park Dr W, Woodbury, NY 11797-2002 | 2008-07-17 |
| 1760690580 | Jack Gerard Skendzel | Orthopaedic Surgery | 2090 Woodwinds Dr, Woodbury, MN 55125-2522 | 2007-05-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699388447 | Erik Therrien | Orthopaedic Surgery | Mayo Clinic 200 1st St Sw Rochester Mn 55905, Rochester, MN 55905-0001 | 2020-08-30 |
| 1619950839 | Bradley James Nelson | Orthopaedic Surgery | 2512 S 7th St, Department of Orthopaedics, R200, Minneapolis, MN 55454-1404 | 2005-11-22 |
| 1902381148 | Richard Kyle Maciver Martin | Orthopaedic Surgery | 200 1st St Sw, Rochester, MN 55905-0001 | 2018-10-02 |
| 1174008288 | Maen Abou-ghaida | Orthopaedic Surgery | 323 S Minnesota St, Crookston, MN 56716-1601 | 2018-09-25 |
| 1821502154 | Michael Blake Jacob | Orthopaedic Surgery | 2855 Campus Dr, Plymouth, MN 55441-2649 | 2017-11-22 |
| 1528438116 | Minnesota State University | Orthopaedic Surgery | 135 Myers Fieldhouse, Mankato, MN 56001-6171 | 2015-09-25 |
| 1851705057 | Jonathan James Harvey | Orthopaedic Surgery | 111 17th Ave E Ste 101, Alexandria, MN 56308-5274 | 2014-06-16 |
| 1861802019 | Adam Morgan Johannsen | Orthopaedic Surgery | 14000 Fairview Dr, Burnsville, MN 55337-5713 | 2014-04-28 |
| 1508156571 | Ryan Robert Fader | Orthopaedic Surgery | 8100 W 78th St Ste 225, Edina, MN 55439-2569 | 2011-04-12 |
| 1396056842 | Zachary Peter Arntson | Orthopaedic Surgery | 8540 Quaday Ave Ne, Otsego, MN 55330-6522 | 2010-06-30 |
| 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.