NORTH MEMORIAL HEALTH CARE (NPI# 1518493170) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518493170 |
| Entity Type | Organization |
| Organization Name | NORTH MEMORIAL HEALTH CARE |
| Other Organization Name | NORTH MEMORIAL HEALTH CLINIC - ROSEVILLE |
| Practice Address |
1835 County Road C W #150 Roseville MN 55113-1352 |
| Mailing Address |
3300 Oakdale Ave N Robbinsdale MN 55422-2926 |
| Practice Telephone | 7637854500 |
| Practice Fax Number | 7637857779 |
| Enumeration Date | 2017-05-02 |
| 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 - Roseville | 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 |
1835 COUNTY ROAD C W #150 |
| City | ROSEVILLE |
| State | MN |
| Zip Code | 55113-1352 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588630925 | Derek Allen Moline | Optometrist | 1835 County Road C W, Suite 140, Roseville, MN 55113-1352 | 2006-02-26 |
| 1366899437 | Chloe Ferrar | Physician Assistant | 1835 County Road C W, Roseville, MN 55113-1352 | 2016-05-18 |
| 1598125064 | Lauren H Massopust | Physician Assistant | 1835 County Road C W, 150, Roseville, MN 55113-1352 | 2016-02-26 |
| 1811356397 | Jeremiah Lynch | Physician Assistant | 1835 County Road C W, Roseville, MN 55113-1352 | 2016-02-12 |
| 1104201284 | Pdg, Pa | Clinic/Center | 1835 County Road C W, Suite 200, Roseville, MN 55113 | 2015-07-30 |
| 1477950475 | Kelsey L Holmes | Physician Assistant | 1835 County Road C W, 250, Roseville, MN 55113-1352 | 2014-11-20 |
| 1578822599 | Hunter Hendry Piermont | Student in an Organized Health Care Education/Training Program | 1835 County Road C W, Suite 220, Roseville, MN 55113-1352 | 2012-05-11 |
| 1801152814 | Amdahl Hearing, Inc. | Clinic/Center | 1835 County Road C W, Ste. 80, Roseville, MN 55113-1352 | 2012-04-03 |
| 1063782621 | Tareen Dermatology, P.a. | Non-Pharmacy Dispensing Site | 1835 County Road C W, 250, Roseville, MN 55113-1352 | 2012-01-12 |
| 1558659615 | Jason Michael Prostrollo | Pediatrics | 1835 County Road C W, Roseville, MN 55113-1352 | 2011-07-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396384376 | Zachary Mattson | Physician Assistant | Regus Coworking Space 2355 Highway 36 West, Suite 400, Office #427, Roseville, MN 55113 | 2019-12-23 |
| 1467010330 | Ahmed Issa | Student in an Organized Health Care Education/Training Program | 1550 Larpenteur Ave W, Apt 235, St Paul, MN 55113 | 2019-06-05 |
| 1821653833 | Suite Living Senior Care of Little Canada | Assisted Living Facility | 2740 Rice Street, Little Canada, MN 55113 | 2019-05-06 |
| 1902370505 | Diverse Assessments and Treatment, LLC | Psychologist | 1935 Cty Rd B2 W Ste 270, Roseville, MN 55113 | 2019-01-16 |
| 1588138473 | Applewood Home Health Care, LLC | Home Health | 2021 E Hennepin Avenue # 402-1, Minneapolis, MN 55113 | 2019-01-14 |
| 1699251520 | Optum Infusion Services 500, Inc. | Durable Medical Equipment & Medical Supplies | 2685 Patton Rd, Roseville, MN 55113 | 2018-07-13 |
| 1083104145 | Suite Living Senior Care of Roseville | Assisted Living Facility | 197 County Road B2 W, Roseville, MN 55113 | 2018-05-15 |
| 1477055796 | Sunrise Residential Services LLC | Home Health | 216 Maple Ln, Roseville, MN 55113 | 2018-03-02 |
| 1194223024 | Alissa Hoff | Specialist | 1595 Mn 36 - 584 10 Rosedale Center, Roseville, MN 55113 | 2018-01-25 |
| 1841705118 | Kingsland Care Services Incorporated | Case Management | 2301 Rice Street, Suite 101, Roseville, MN 55113 | 2017-12-08 |
| Find all providers in zip 55113 | ||||
| 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 |
|---|---|---|---|---|
| 1275000283 | Saint Paul Hyperbaric Oxygen Center, P.a | Clinic/Center | 2151 Hamline Ave N Ste 111b, Roseville, MN 55113-4226 | 2018-10-29 |
| 1235666108 | Charter Professional Group Inc | Clinic/Center | 775 Sunrise Ave Ste 140, Roseville, CA 95661-4527 | 2017-05-22 |
| 1508979089 | Ecg Scanning & Medical Services Inc | Clinic/Center | 18223 E Ten Mile Road, Suite 300, Roseville, MI 48066-5281 | 2006-08-17 |
| 1881170397 | East West Acupuncture Center | Clinic/Center | 151 N Sunrise Ave Ste 819, Roseville, CA 95661-2928 | 2018-07-17 |
| 1972968337 | Core Chiropractic & Health | Clinic/Center | 1611 County Road B W Ste 106, Roseville, MN 55113-5021 | 2015-12-29 |
| 1295072254 | Diagnostic Evaluation Services | Clinic/Center | 800 Douglas Blvd, Roseville, CA 95678-2711 | 2013-01-11 |
| 1598032070 | Harper Dermatology P.C. | Clinic/Center | 18285 E 10 Mile Rd, Suite 130, Roseville, MI 48066-5802 | 2011-11-28 |
| 1326212184 | Community Drug& Alcohol Services Inc | Clinic/Center | 2675 Long Lake Rd Ste 125, Roseville, MN 55113-2823 | 2008-04-14 |
| 1275670754 | Putman Chiropractic Inc | Clinic/Center | 584 N Sunrise Ave, Ste. 130, Roseville, CA 95661-2862 | 2007-01-31 |
| 1376633511 | Advanced Injury Rehabilitation, Ltd. | Clinic/Center | 1752 Lexington Ave N, Roseville, MN 55113-6516 | 2006-10-16 |
| Find all providers in ROSEVILLE | ||||
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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.