MARY ANNE JACOB (NPI# 1659348399) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659348399 |
| Entity Type | Individual |
| Full Name | MARY ANNE JACOB |
| Credential | MD |
| Practice Address |
6545 France Avenue South Suite 540 Edina MN 55435 |
| Practice Telephone | 9529274045 |
| Practice Fax Number | 9529244133 |
| Mailing Telephone | 9529274045 |
| Mailing Fax Number | 9529244133 |
| Enumeration Date | 2006-03-01 |
| Last Update Date | 2016-04-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | 41934 | MN | Allopathic & Osteopathic Physicians |
| N | 207VE0102X |
Obstetrics & Gynecology Specialization: Reproductive Endocrinology |
41934 | MN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | HEALTH PARTNERS | HP29251 | 01 |
| MN | BLUE CROSS/BLUE SHIELD | 11D21JA | 01 |
| MN | 252025700 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518425982 | Mary Deena Jacob | Nurse Practitioner | 2865 Mcdermott Rd #225, Plano, TX 75025 | 2019-03-05 |
| 1124537667 | Mary Jacob | Dentist | 334 Broadway, Revere, MA 02151-5016 | 2017-09-27 |
| 1164774071 | Mary Jacob | Pharmacist | 16 S Waukegan Rd, Deerfield, IL 60015-5216 | 2012-10-03 |
| 1225321755 | Mary Sunny Jacob | Emergency Medicine | 2150 Pennsylvania Ave Nw, Washington, DC 20037-3201 | 2011-05-17 |
| 1194741041 | Mary Ann Jacob | Pediatrics | 2841 Debarr Rd, Suite 45, Anchorage, AK 99508-2932 | 2006-07-14 |
| 1396776571 | Mary R Jacob | Clinical Nurse Specialist | 1600 S Orlando Ave, Winter Park, FL 32789-5547 | 2006-07-05 |
| 1083612246 | Mary Casey Jacob | Psychologist | 263 Farmington Ave, Farmington, CT 06030-0001 | 2005-07-12 |
| Street Address |
6545 FRANCE AVENUE SOUTH SUITE 540 |
| City | EDINA |
| State | MN |
| Zip Code | 55435 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972509255 | David J Walcher | Internal Medicine | 6545 France Avenue South, Suite 510, Edina, MN 55435 | 2005-06-22 |
| 1821210212 | Jacob Charles Liston | Internal Medicine | 6545 France Avenue South, Suite 510, Edina, MN 55435 | 2007-05-03 |
| 1437233525 | Mary L Maki Setre | Nurse Practitioner | 6545 France Avenue South, Suite 540, Edina, MN 55435 | 2006-10-25 |
| 1346207149 | Southdale Internal Medicine Pa | Internal Medicine | 6545 France Avenue South, Suite 510, Edina, MN 55435 | 2006-04-27 |
| 1417924614 | Elisa M Wright | Obstetrics & Gynecology | 6545 France Avenue South, Suite 540, Edina, MN 55435 | 2006-03-07 |
| 1598730756 | Juan C Angelats | Obstetrics & Gynecology | 6545 France Avenue South, Suite 540, Edina, MN 55435 | 2006-02-21 |
| 1558367847 | Gary L Brunkow | Internal Medicine | 6545 France Avenue South, Suite 510, Edina, MN 55435 | 2005-06-22 |
| 1053317354 | Merlin Emery Brown | Internal Medicine | 6545 France Avenue South, Suite 510, Edina, MN 55435 | 2005-06-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104433416 | Evy Christine Claussen | Social Worker | 6363 France Ave. S., Edina, MN 55435 | 2020-09-30 |
| 1508496621 | Samantha Jean Mcgough Lamere | Physician Assistant | 4300 Marketpointe Drive, Suite 100, Bloomington, MN 55435 | 2020-01-16 |
| 1659920460 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 3408 Galleria, Edina, MN 55435 | 2019-09-05 |
| 1730651639 | Taylor Lee Kehoe | Physician Assistant | 7400 France Ave., Suite #100, Edina, MN 55435 | 2018-12-18 |
| 1538666326 | Amanda Deangelo | Physical Therapist | 6401 Southdale Hospital, Ll3g, Edina, MN 55435 | 2018-04-09 |
| 1982107876 | Julia Seliber | Dental Hygienist | 7600 France Ave.s. Suite 1100, Edina, MN 55435 | 2018-03-16 |
| 1154840064 | Southhealth Asc, LLC | Clinic/Center | 4100 Minnesota Drive, Edina, MN 55435 | 2017-09-12 |
| 1730605528 | Edina Medical Supplies | Durable Medical Equipment & Medical Supplies | 7455 France Ave., #614 S, Edina, MN 55435 | 2017-08-14 |
| 1033565510 | Minnesota Disc Replacement and Spine Restoration Center | Clinic/Center | 4444 76 St, #700, Edina, MN 55435 | 2016-05-13 |
| 1306206321 | Barb Ryan | Mechanotherapist | 7550 France Avenue S, #220, Edina, MN 55435 | 2016-03-03 |
| Find all providers in zip 55435 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285052027 | Paige Persch | Obstetrics & Gynecology | 6565 France Ave S Ste 300, Edina, MN 55435-2154 | 2014-03-30 |
| 1851529739 | Kellie Christine Lease-stecher | Obstetrics & Gynecology | 6525 France Ave S Ste 100, Edina, MN 55435-2158 | 2009-06-30 |
| 1033365853 | Allina Health System | Obstetrics & Gynecology | 6525 France Ave S Ste 205, Edina, MN 55435-2176 | 2008-08-12 |
| 1245490952 | Jewelia Wagner | Obstetrics & Gynecology | 6545 France Ave S Ste 490, Edina, MN 55435 | 2008-06-16 |
| 1043486301 | Rachel Amanda Harris | Obstetrics & Gynecology | 3625 W 65th St Ste 100, Edina, MN 55435-2147 | 2008-05-06 |
| 1154531192 | Jessica L Grajczyk | Obstetrics & Gynecology | 6405 France Ave. South, Suite W400, Edina, MN 55435-2192 | 2007-05-22 |
| 1215143383 | Erin A. Collins | Obstetrics & Gynecology | 6525 France Ave. S Suite #100, Paul Larson O.b. Gyn., Edina, MN 55435 | 2007-05-15 |
| 1801946223 | Premier Obgyn of Minnesota Pa | Obstetrics & Gynecology | 3625 W. 65th Street, Suite 100, Edina, MN 55435 | 2007-01-10 |
| 1265545784 | Stephanie K Dahl | Obstetrics & Gynecology | 6565 France Ave S Ste 400, Edina, MN 55435-2137 | 2006-08-17 |
| 1851345177 | Melissa A O'halloran | Obstetrics & Gynecology | 3625 W 65th St, Suite 100, Edina, MN 55435-2106 | 2006-05-20 |
| Find all providers in EDINA | ||||
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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.