FAMILY HEALTHSERVICES MINNESOTA, P.A. (NPI# 1588807895) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588807895 |
| Entity Type | Organization |
| Organization Name | FAMILY HEALTHSERVICES MINNESOTA, P.A. |
| Other Organization Name | FHSM - GORMAN CLINIC |
| Practice Address |
234 Wentworth Ave E West St Paul MN 55118-3525 |
| Mailing Address |
5626 Oberlin Dr Suite 110 San Diego CA 92121-1705 |
| Practice Telephone | 6514552940 |
| Enumeration Date | 2009-04-16 |
| Last Update Date | 2012-10-23 |
| NPI Deactivation Date | 12/16/2009 |
| NPI Reactivation Date | 2010-03-22 |
| Authorized Official Name | KENNY HEINE (DIRECTOR OF OPERATIONS) |
| Authorized Official Telephone | 8586252990 |
| Is Organization Subpart | Y |
| Parent Organization Name | MEDVANTX, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332900000X | Non-Pharmacy Dispensing Site | 23358 | MN | Suppliers |
| Other Name | Type Code |
|---|---|
| FHSM - Gorman Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124206677 | Family Healthservices Minnesota, P.a. | Family Medicine | 2025 Sloan Pl, Suite 35, Saint Paul, MN 55117-2007 | 2008-02-07 |
| 1427190537 | Family Healthservices Minnesota, P.a. | Non-Pharmacy Dispensing Site | 1814 N Saint Paul Rd, Maplewood, MN 55109-4700 | 2007-02-13 |
| 1528248259 | Family Healthservices Minnesota, P.a. | Family Medicine | 3550 Labore Rd, Suite 7, Saint Paul, MN 55110-7505 | 2007-11-09 |
| 1437339165 | Family Healthservices Minnesota, P.a. | Family Medicine | 3220 Bellaire Ave, White Bear Lake, MN 55110-5854 | 2007-11-09 |
| 1538349253 | Family Healthservices Minnesota, P.a. | Family Medicine | 2980 Buckley Way, Inver Grove Heights, MN 55076-2017 | 2007-11-09 |
| 1790965424 | Family Healthservices Minnesota, P.a. | Family Medicine | 2056 Woodlane Dr, Woodbury, MN 55125-2917 | 2007-11-09 |
| 1629258348 | Family Healthservices Minnesota, P.a. | Family Medicine | 1540 Randolph Ave, Saint Paul, MN 55105-2535 | 2007-11-09 |
| 1538349261 | Family Healthservices Minnesota, P.a. | Family Medicine | 1814 N Saint Paul Rd, Maplewood, MN 55109-4700 | 2007-11-09 |
| 1639359359 | Family Healthservices Minnesota, P.a. | Family Medicine | 4786 Banning Ave, White Bear Lake, MN 55110-3264 | 2007-11-09 |
| 1801076526 | Family Healthservices Minnesota, P.a. | Family Medicine | 234 Wentworth Ave E, West St Paul, MN 55118-3525 | 2007-11-09 |
| Street Address |
234 WENTWORTH AVE E |
| City | WEST ST PAUL |
| State | MN |
| Zip Code | 55118-3525 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801076526 | Family Healthservices Minnesota, P.a. | Family Medicine | 234 Wentworth Ave E, West St Paul, MN 55118-3525 | 2007-11-09 |
| 1790796761 | Michelle W Chestovich | Family Medicine | 234 Wentworth Ave E, West St Paul, MN 55118-3525 | 2006-08-11 |
| 1790796779 | Johanna Toninato | Family Medicine | 234 Wentworth Ave E, West St Paul, MN 55118-3525 | 2006-08-11 |
| 1093726077 | John O Punderson | Family Medicine | 234 Wentworth Ave E, West St Paul, MN 55118-3525 | 2006-08-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033764428 | Able Solutions LLC | Day Training, Developmentally Disabled Services | 260 E Wentworth Ave Suite 112, St Paul, MN 55118 | 2019-08-03 |
| 1861059974 | Tanya F Langford | Massage Therapist | 3627 Cedar Ave No., 1166 S Robert St. St. Paul West, St. Paul, MN 55118 | 2019-05-23 |
| 1396210779 | Southview Operations LLC | Skilled Nursing Facility | 2000 Oakdale Avenue, West St. Paul, MN 55118 | 2018-10-11 |
| 1538643424 | Marcus James Rohrbauck | Social Worker | 1312-1314 Livingston Avenue, West St. Paul, MN 55118 | 2018-09-18 |
| 1609394287 | Eric Graham Dorr | Pharmacist | 149 Thompson Ave East, Suite 150, West Saint Paul, MN 55118 | 2017-09-05 |
| 1518485242 | Meaghan Claire Puckett | Marriage & Family Therapist | 33 Wentworth Ave E Ste 210, West St Paul, MN 55118 | 2017-09-01 |
| 1174078307 | Michal Frank | Counselor | 240 Dakota St, West Saint Paul, MN 55118 | 2016-08-17 |
| 1184011868 | Rachel Devries | Pediatrics | 1880 Livingston Ave Ste 102, West St Paul, MN 55118 | 2015-04-21 |
| 1124411772 | Ahmed Salad Associates | Dentist | 1200 S Robert St, Suite C, St Paul, MN 55118 | 2015-03-06 |
| 1225458458 | Shellea J Altman | Dentist | 576 High Ridge Circle, Mendota Heights, MN 55118 | 2014-04-28 |
| Find all providers in zip 55118 | ||||
| Taxonomy Code | 332900000X |
| Grouping | Suppliers |
| Classification | Non-Pharmacy Dispensing Site |
| A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518528397 | Fairview Pharmacy Services LLC | Non-Pharmacy Dispensing Site | Fairview Lakeville Clinic Mtm, 18580 Joplin Ave, Lakeville, MN 55044 | 2019-06-24 |
| 1851856504 | Tareen Dermatology, Pa | Non-Pharmacy Dispensing Site | 2945 Hazelwood St Ste 230, Maplewood, MN 55109-1241 | 2019-02-07 |
| 1417450651 | Cerner Health Connections, Inc | Non-Pharmacy Dispensing Site | 4001 Lexington Ave N Ste C2-435, Arden Hills, MN 55126-2934 | 2018-03-14 |
| 1316461593 | Fairview Pharmacy Service LLC | Non-Pharmacy Dispensing Site | 7250 France Ave S Ste 410, Edina, MN 55435-4314 | 2017-07-31 |
| 1346653052 | Advanced Spine and Pain Clinics of Mn, LLC | Non-Pharmacy Dispensing Site | 308 Brighton Ave, Suite D, Buffalo, MN 55313-2303 | 2014-06-10 |
| 1407296148 | Group Health Plan Inc | Non-Pharmacy Dispensing Site | 1833 2nd Ave, Anoka, MN 55303-2432 | 2013-06-26 |
| 1295178135 | Fairview Pharmacy Services LLC | Non-Pharmacy Dispensing Site | 6440 Nicollet Ave South, Richfield, MN 55423-1613 | 2013-04-10 |
| 1992148845 | Fairview Pharmacy Services LLC | Non-Pharmacy Dispensing Site | 2450 Riverside Ave South, Minneapolis, MN 55454-1400 | 2013-04-10 |
| 1083984876 | Mayo Clinic Health System-southeast Minnesota Region | Non-Pharmacy Dispensing Site | 32021 County 24 Boulevard, Cannon Falls, MN 55009-1824 | 2012-01-10 |
| 1255623765 | Mankato Clinic, Ltd | Non-Pharmacy Dispensing Site | 305 Main St Ne, Mapleton, MN 56065 | 2011-05-03 |
| Find all providers with the same taxonomy | ||||
| City | WEST ST PAUL |
| Zip Code | 55118 |
Please comment or provide details below to improve the information on FAMILY HEALTHSERVICES MINNESOTA, P.A..
| 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.