ANDRE ROBERSON (NPI# 1629546072) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629546072 |
| Entity Type | Individual |
| Full Name | ANDRE ROBERSON |
| Practice Address |
1110 Evergreen Ln N Plymouth MN 55441-4834 |
| Practice Telephone | 7632007441 |
| Mailing Telephone | 7632007441 |
| Enumeration Date | 2018-11-04 |
| Last Update Date | 2018-11-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 372600000X | Adult Companion | MN | Nursing Service Related Providers |
| Street Address |
1110 EVERGREEN LN N |
| City | PLYMOUTH |
| State | MN |
| Zip Code | 55441-4834 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114485927 | Elevate Transportation Services Inc | Taxi | 1110 Evergreen Ln N, Plymouth, MN 55441-4834 | 2019-03-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689190019 | The Recovery Clinic LLC | Clinic/Center | 9800 Shelard Pkwy Ste 215, Plymouth, MN 55441 | 2017-08-17 |
| 1356887186 | Katherine Marlow Bell | Dentist | 2805 Campus Dr Ste 245, Plymouth, MN 55441 | 2017-01-18 |
| 1083069538 | Mercade Waldon | Home Health Aide | 3501 Xenium Lane, Plymouth, MN 55441 | 2016-05-03 |
| 1346645538 | Phs Westhealth, Inc | Skilled Nursing Facility | 2775 Campus Drive North, Plymouth, MN 55441 | 2014-10-30 |
| 1427453125 | Samuel David Fine | Pharmacist | 4070 Goldenrod Ln, Plymouth, MN 55441 | 2014-10-24 |
| 1548672538 | Scott Aaron Schmidt | Dentist | 2720 Annapolis Circle N, Suite A, Plymouth, MN 55441 | 2014-05-23 |
| 1831498633 | Comforide Transportation Services LLC | Non-emergency Medical Transport (VAN) | 9730 37th Pl N Suite 201, Plymouth, MN 55441 | 2011-03-18 |
| 1255669271 | Tammy Kae Mehlhaus | Physician Assistant | 2855 Campus Drive, Suite 570, Plymouth, MN 55441 | 2009-12-02 |
| 1164758199 | Stephen P. Boger, Dds, Pa | Dentist | 2720 Annapolis Circle, Suite A, Plymouth, MN 55441 | 2009-10-27 |
| 1093908360 | Endodontic Professionals Pa Plymouth Endodontics | Dentist | 3401 Hwy 169 N, Plymouth, MN 55441 | 2007-08-21 |
| Find all providers in zip 55441 | ||||
| Taxonomy Code | 372600000X |
| Grouping | Nursing Service Related Providers |
| Classification | Adult Companion |
| An individual who provides supervision, socialization, and non-medical care to a functionally impaired adult. Companions may assist or supervise the individual with such tasks as meal preparation, laundry and shopping, but do not perform these activities as discrete services. These services are provided in accordance with a therapeutic goal in the plan of care. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437526639 | Kurt Kazanowski | Adult Companion | 296 S Main St Ste 203, Plymouth, MI 48170-4256 | 2015-08-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881292944 | Reliable Quality Care LLC | Adult Companion | 1121 Hamline Ave N Unit 201, Saint Paul, MN 55108-2756 | 2020-10-12 |
| 1922605666 | Toujours Care Corp | Adult Companion | 16336 Jamison Path, Lakeville, MN 55044-6613 | 2020-10-06 |
| 1245855816 | Eric John Peltz | Adult Companion | 898 322nd Ave Ne, Cambridge, MN 55008-5810 | 2020-06-10 |
| 1497383392 | Jennifer Clement | Adult Companion | 1426 Oliver Ave N Apt 2, Minneapolis, MN 55411-3033 | 2020-03-28 |
| 1902430879 | Golden Years Home | Adult Companion | 506 4th St Sw, Montgomery, MN 56069-1222 | 2020-02-28 |
| 1154965721 | Lansa Dawano | Adult Companion | 3707 104th Trl N, Minneapolis, MN 55443-1012 | 2019-11-06 |
| 1134786130 | Mohamed Shido Hassan | Adult Companion | 1312 7th St Nw Ste 203, Rochester, MN 55901-1704 | 2019-05-24 |
| 1457917262 | Pang Yang | Adult Companion | 12844 Raven St Nw, Coon Rapids, MN 55448-2578 | 2019-05-16 |
| 1407349566 | Twins Care LLC | Adult Companion | 393 Dunlap St N Ste Ll44, Saint Paul, MN 55104-4237 | 2018-06-12 |
| 1578067344 | Taylor Lee Andrews | Adult Companion | 777 Dague Ave Ne, Buffalo, MN 55313-4214 | 2018-03-19 |
| 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.