JACK GRAY BEAIRD (NPI# 1407810286) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407810286 |
| Entity Type | Individual |
| Full Name | JACK GRAY BEAIRD |
| Credential | MD |
| Practice Address |
407 W 66th St Richfield MN 55423-2374 |
| Mailing Address |
2925 Chicago Ave Minneapolis MN 55407-1321 |
| Practice Telephone | 6127988800 |
| Practice Fax Number | 6127988816 |
| Mailing Telephone | 6122625000 |
| Enumeration Date | 2006-04-17 |
| Last Update Date | 2020-11-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0300X |
Internal Medicine Specialization: Geriatric Medicine |
21323 | MN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 194380400 | 05 |
| Street Address |
407 W 66TH ST |
| City | RICHFIELD |
| State | MN |
| Zip Code | 55423-2374 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689670150 | Samuel W Spears | Internal Medicine | 407 W 66th St, Richfield, MN 55423-2304 | 2005-06-21 |
| 1316326549 | Hannah Smith | Dietitian, Registered | 407 W 66th St, Richfield, MN 55423-2304 | 2015-05-20 |
| 1992197073 | Mckaya Kastner | Pharmacist | 407 W 66th St, Richfield, MN 55423-2304 | 2015-02-25 |
| 1639437122 | Junaid Niazi | Internal Medicine | 407 W 66th St, Richfield, MN 55423-2304 | 2012-05-02 |
| 1114285319 | Anne Kathryn Scherman | Family Medicine | 407 W 66th St, Richfield, MN 55423-2304 | 2012-04-25 |
| 1306142054 | Allina Health System | Clinic/Center | 407 W 66th St, Richfield, MN 55423-2304 | 2011-01-27 |
| 1336450683 | Elizabeth A Koffel | Internal Medicine | 407 W 66th St, Richfield, MN 55423-2304 | 2010-07-01 |
| 1851618169 | Lauren Beth Haveman | Internal Medicine | 407 W 66th St, Richfield, MN 55423-2304 | 2010-04-26 |
| 1104093194 | Lindsey M Pritchard | Pharmacist | 407 W 66th St, Richfield, MN 55423-2304 | 2008-05-09 |
| 1073703567 | Amy Brendel | Internal Medicine | 407 W 66th St, Richfield, MN 55423-2304 | 2007-07-31 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841844081 | Ann Niebuhr | Counselor | 6417 Penn Ave S Ste 8 #2, Minneapolis, MN 55423 | 2019-07-25 |
| 1073021077 | Alton John Olson | Surgery | 7008 - Morgan Avenue South, Richfield, MN 55423 | 2018-01-12 |
| 1992238190 | Certified Care Planner LLC | Home Health | 1515 E 66th Street Suite 105, Richfield, MN 55423 | 2017-04-05 |
| 1245780121 | Rachel Lauren Marston | Audiologist | 7745 2nd Ave S., Suite 1, Richfield, MN 55423 | 2016-10-04 |
| 1023564093 | Justine Welch Mastin | Counselor | 6640 Lyndale Ave S Ste 110, Minneapolis, MN 55423 | 2016-08-30 |
| 1215480942 | Smart Choice Mri, LLC | Clinic/Center | 1704 E 66th St, Minneapolis, MN 55423 | 2016-07-29 |
| 1225425531 | Maria Lourdes Nolasco De Leon | Registered Nurse | 6511 12th Ave. S, Richfield, MN 55423 | 2015-04-24 |
| 1508261926 | Ally Medical Supply | Durable Medical Equipment & Medical Supplies | 6238 Lyndale Ave South, Suite # 2, Richfield, MN 55423 | 2014-10-28 |
| 1811230097 | Barb Rose Olson | Registered Nurse | 6461 Lyndale Ave. So, Richfield, MN 55423 | 2013-04-05 |
| 1902149404 | Nina Kae Hanevik | Registered Nurse | 6461 Lyndale Ave So, Richfield, MN 55423 | 2013-04-03 |
| Find all providers in zip 55423 | ||||
| Taxonomy Code | 207RG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Geriatric Medicine |
| An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033465505 | Manji Belinda Osifeso | Internal Medicine | 790 West 66th Street, Hcmc Richfield Clinic, Richfield, MN 55423 | 2012-08-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083268189 | Mission Creek Transitional Care Pllc | Internal Medicine | 520 Marshall St, Duluth, MN 55803-1981 | 2019-07-26 |
| 1275191736 | Howide Eldib | Internal Medicine | 4728 Lyndale Ave S Apt 1, Minneapolis, MN 55419-5304 | 2019-05-30 |
| 1689007940 | David Pautz | Internal Medicine | 6313 Westwood Ct, Edina, MN 55436-1149 | 2013-08-09 |
| 1508147224 | Jane Carol Pederson | Internal Medicine | 9478 Wedgewood Dr, Woodbury, MN 55125-9304 | 2011-09-08 |
| 1336445899 | Diane Helen Scott | Internal Medicine | 2545 Hamline Ave N, Apt 211, Roseville, MN 55113 | 2011-02-01 |
| 1497981286 | House Call Specialists, Pllc | Internal Medicine | 115 Oregon Ave S, Golden Valley, MN 55426-1561 | 2009-06-07 |
| 1952582744 | Maged Labib | Internal Medicine | 1920 Mineral Springs Pkwy, Owatonna, MN 55060-2186 | 2007-11-20 |
| 1912118522 | Bernadette Kim Quadling | Internal Medicine | 1415 Lilac Dr N, Ste 190, Golden Valley, MN 55422-4544 | 2007-05-25 |
| 1912046988 | Margaret Rice, Md, Pa | Internal Medicine | 4901 Garfield Ave, Minneapolis, MN 55419-5403 | 2007-02-06 |
| 1649329038 | Dennis S Hsieh | Internal Medicine | 9800 Health Care Ln, Mail Route Pa950-1000, Minnetonka, MN 55343 | 2007-01-09 |
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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.