LIFE WELLNESS CENTER-EAGAN, PA (NPI# 1699106773) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699106773 |
| Entity Type | Organization |
| Organization Name | LIFE WELLNESS CENTER-EAGAN, PA |
| Practice Address |
1895 Plaza Dr Suite 200 Eagan MN 55122-4600 |
| Practice Telephone | 6516888886 |
| Practice Fax Number | 6516882702 |
| Mailing Telephone | 6516888886 |
| Mailing Fax Number | 6516882702 |
| Enumeration Date | 2013-11-27 |
| Last Update Date | 2020-03-26 |
| Authorized Official Name | THOMAS SCHMIDT (OWNER) |
| Authorized Official Telephone | 9524355300 |
| Authorized Official Credential | DC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 111N00000X | Chiropractor | Chiropractic Providers | ||
| N | 225100000X | Physical Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| Street Address |
1895 PLAZA DR SUITE 200 |
| City | EAGAN |
| State | MN |
| Zip Code | 55122-4600 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932275971 | Pdg, P.a. | Dentist | 1895 Plaza Dr, Suite 130, Eagan, MN 55122-4600 | 2006-11-28 |
| 1194042135 | Emergent Health Chiropractic Wellness, Inc | Chiropractor | 1895 Plaza Dr, Suite 200, Eagan, MN 55122-4600 | 2010-04-30 |
| 1740438076 | Dental Specialists of Minnesota, Pllc | Dentist | 1895 Plaza Dr, Suite 130, Eagan, MN 55122-4600 | 2008-08-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730651753 | Alvaro Jesus Jimenez Aguilar | Registered Nurse | 1764 Silver Bell Rd, Eagan, MN 55122 | 2019-01-02 |
| 1194213280 | Amherst H. Wilder Foundation | Lodging | Lincoln Place, 1997 Gold Trail, Eagan, MN 55122 | 2018-04-25 |
| 1831541168 | Mackenzie Lea Kerber | Counselor | 3410 Federal Dr Suite 101, Eagan, MN 55122 | 2016-07-11 |
| 1285010074 | Eagan Pointe Senior Living | Assisted Living Facility | 4232 Black Hawk Road, Eagan, MN 55122 | 2015-08-04 |
| 1700268828 | Kara Beth Rose | Specialist/Technologist | 4560 Cinnamon Ridge Trail, Eagan, MN 55122 | 2015-06-25 |
| 1558740803 | Samuel Johnson | Physician Assistant | 2901 Metro Drive, Suite 527, Bloomington, MN 55122 | 2015-05-20 |
| 1528451028 | Judi Ross Holistic Therapy, LLC | Marriage & Family Therapist | 4141 Old Sibley Memorial Highway, Eagan, MN 55122 | 2015-03-09 |
| 1447649637 | Leah Ruth Streitman | Physician Assistant | 3460 Washington Dr Ste 200, Eagan, MN 55122 | 2015-01-12 |
| 1518362193 | Cedar Valley Center for Child & Family Therapy | Preferred Provider Organization | 3460 Washington Dr., Suite 110, Eagan, MN 55122 | 2014-10-25 |
| 1316351703 | Wecare Dental of Eagan P.c | Clinic/Center | 1625 Lena Court Suite 100, Eagan, MN 55122 | 2014-06-13 |
| Find all providers in zip 55122 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447654678 | Chs Tennessee Medical, P.C. | General Practice | 610 Opperman Dr, Thomson Reuters Campus, Eagan, MN 55123-1340 | 2014-10-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447857230 | Minneapolis Integrative Medicine Center, LLC | General Practice | 575 9th St Se Ste 52, Minneapolis, MN 55414-1399 | 2020-10-05 |
| 1811518137 | Falls Medical Group, Pllc | General Practice | 1580 Highway 11-71, International Falls, MN 56649 | 2020-04-27 |
| 1013561893 | Medexpress Primary Care Minnesota, P.C. | General Practice | 4316 Rice Lake Rd, Duluth, MN 55811-4012 | 2019-07-30 |
| 1245790211 | Fairview Clinics | General Practice | 303 E Nicollet Blvd Ste 260, Burnsville, MN 55337-4522 | 2019-03-25 |
| 1316422397 | Fairview Health Services | General Practice | 7411 85th Ave N, Brooklyn Park, MN 55445-2231 | 2018-09-26 |
| 1841716883 | Medexpress Primary Care Minnesota, P.C. | General Practice | 11030 Optum Cir, Eden Prairie, MN 55344-2503 | 2017-08-22 |
| 1922422989 | Roger J. Day | General Practice | 9701 Xebec St Ne, Circle Pines, MN 55014-2508 | 2014-02-12 |
| 1760724827 | Ahmednur Abdirahman | General Practice | 10750 Brunswick Rd Apt 111, Bloomington, MN 55438-1860 | 2013-03-26 |
| 1225385891 | Felix Cristobal Blanco | General Practice | 10 Fourth Ave Se, Glenwood, MN 56334-1820 | 2012-08-13 |
| 1689930554 | Linda Gail Olson | General Practice | 17935 24th Ave N, Minneapolis, MN 55447 | 2012-04-05 |
| 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.