MINCEP EPILEPSY CARE PA (NPI# 1730211863) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730211863 |
| Entity Type | Organization |
| Organization Name | MINCEP EPILEPSY CARE PA |
| Other Organization Name | MINNESOTA COMPREHENSIVE EPILEPSY PROGRAM, P.A. |
| Practice Address |
5775 Wayzata Blvd Suite 200 St Louis Park MN 55416-1222 |
| Practice Telephone | 9525254511 |
| Practice Fax Number | 9525251560 |
| Mailing Telephone | 9525254511 |
| Mailing Fax Number | 9525251560 |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. ROBERT GUMNIT (PRESIDENT, MEDICAL DIRECTOR) |
| Authorized Official Telephone | 9525254511 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | U CARE NUMBER | 103730 | 01 |
| Other Name | Type Code |
|---|---|
| Minnesota Comprehensive Epilepsy Program, P.A. | Doing Business As Name - Organization |
| Street Address |
5775 WAYZATA BLVD SUITE 200 |
| City | ST LOUIS PARK |
| State | MN |
| Zip Code | 55416-1222 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073592960 | Mark E Myers | Radiology | 5775 Wayzata Blvd, Suite 190, St Louis Park, MN 55416-1222 | 2006-01-10 |
| 1972029247 | Scott Michael Curran | Social Worker | 5775 Wayzata Blvd, Ste 255, St Louis Park, MN 55415-5541 | 2017-08-18 |
| 1033581970 | Dennis Philander, Md, Pa | Psychiatry & Neurology | 5775 Wayzata Blvd, Suite 700, St Louis Park, MN 55416-1222 | 2015-10-29 |
| 1649648411 | Kayla James | Social Worker | 5775 Wayzata Blvd, St Louis Park, MN 55416-1222 | 2015-09-09 |
| 1801209259 | Golden Generation Senior Care Inc. | Skilled Nursing Facility | 5775 Wayzata Blvd, Ste 700, St Louis Park, MN 55416-1222 | 2014-06-03 |
| 1720411945 | Bieta Kia | Physical Therapist | 5775 Wayzata Blvd, Suite 900, St Louis Park, MN 55416-1222 | 2013-08-12 |
| 1578832457 | Heather Paige Harper | Registered Nurse | 5775 Wayzata Blvd, Suite 255, St Louis Park, MN 55416-1222 | 2011-12-21 |
| 1215245113 | Celebrity Home Health Partners, LLC | Home Health | 5775 Wayzata Blvd, Suite 700, St Louis Park, MN 55416-1222 | 2010-09-14 |
| 1275840928 | Beatrice Rue | Licensed Practical Nurse | 5775 Wayzata Blvd, Suite 700, St Louis Park, MN 55416-1222 | 2010-09-01 |
| 1356658009 | Thomas Benson | Registered Nurse | 5775 Wayzata Blvd, Suite 700, St Louis Park, MN 55416-1222 | 2010-09-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639711492 | Ismahan Abdirahman Mohamed | Psychologist | 4236 Parkglen Rd, St Louis Park, MN 55416 | 2019-10-14 |
| 1598307860 | Ayman Abulaziz Mohamed | Counselor | 4326 Park Glen Rd, St Louis Park, MN 55416 | 2019-10-08 |
| 1831758929 | Ally Group Homes LLC | Assisted Living Facility | 2944 Princeton Ave South, Saint Louis Park, MN 55416 | 2019-06-11 |
| 1609371525 | Heather Margaret Flatgard | Chiropractor | 5407 Excelsior Blvd Ste D, St Louis Park, MN 55416 | 2018-03-25 |
| 1942702394 | Polaris Pharmacy Services of Minnesota, LLC | Pharmacy | 4220 Park Glen Road, St. Louis Park, MN 55416 | 2018-03-01 |
| 1316469760 | Evert Ray Boyd | Psychologist | 3200 Highway 100 S., Groves Academy, St Louis Park, MN 55416 | 2017-07-07 |
| 1861941684 | Amanda Marie Tapper | Marriage & Family Therapist | 5407 Excelsior Blvd, Suite B, St Louis Park, MN 55416 | 2016-09-22 |
| 1326410416 | Clear Health Chiropractic LLC | Chiropractor | 5614 W 36th St, St. Louis Park, MN 55416 | 2015-10-28 |
| 1568897833 | Kay Elizabeth Lichtenberger | Physical Therapist | 4415 W 36.5 St, St. Louis Park, MN 55416 | 2013-09-05 |
| 1710221510 | Aaron Christopher Oppelt | Counselor | 1665 Utica Ave South - Suite 100, Saint Louis Park, MN 55416 | 2012-11-16 |
| Find all providers in zip 55416 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013054386 | Daniel Kuyper | Psychiatry & Neurology | 3931 Louisiana Ave. S. Suite E500, St Louis Park, MN 55426 | 2007-01-30 |
| 1669851572 | Armin Brian Jewell | Psychiatry & Neurology | 3931 Louisiana Ave S, St Louis Park, MN 55426-5000 | 2015-05-26 |
| 1639512866 | Elliot Mohr Johnson | Psychiatry & Neurology | 3931 Louisiana Ave S, St Louis Park, MN 55426-5000 | 2013-04-08 |
| 1477791580 | Steven Trobiani | Psychiatry & Neurology | 2460 Highway 100 S, St Louis Park, MN 55416-4791 | 2009-01-27 |
| 1972759082 | Darwin Gerardo Ramirez Abreu | Psychiatry & Neurology | 3931 Louisiana Ave S, St Louis Park, MN 55426-5000 | 2008-08-09 |
| 1457375008 | Jeanne Louise Beattie | Psychiatry & Neurology | 3931 Louisiana Ave S, Suite E500, St Louis Park, MN 55426-4375 | 2006-07-27 |
| 1295756518 | Teresa Anh Tran-lim | Psychiatry & Neurology | 6490 Excelsior Blvd, Suite E500, St Louis Park, MN 55426-4705 | 2006-07-21 |
| 1104873314 | Sotirios Andreas Parashos | Psychiatry & Neurology | 3931 Louisiana Ave S, St Louis Park, MN 55426-5000 | 2006-05-31 |
| 1508845272 | Frederick R Taylor Iv | Psychiatry & Neurology | 3931 Louisiana Ave S, Ste E500, St Louis Park, MN 55426-4375 | 2006-01-11 |
| 1033196969 | John M Worley | Psychiatry & Neurology | 6490 Excelsior Blvd, Ste E500, St Louis Park, MN 55426-4705 | 2005-12-30 |
| Find all providers in ST LOUIS PARK | ||||
| City | ST LOUIS PARK |
| Zip Code | 55416 |
Please comment or provide details below to improve the information on MINCEP EPILEPSY CARE PA.
| 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.