GILLETTE CHILDREN'S SPECIALTY HEALTHCARE (NPI# 1730363698) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730363698 |
| Entity Type | Organization |
| Organization Name | GILLETTE CHILDREN'S SPECIALTY HEALTHCARE |
| Other Organization Name | GILLETTE CHILDREN'S SPECIALTY HEALTHCARE- GROVE HEALTH |
| Practice Address |
9550 Upland Lane North Suite 220 Maple Grove MN 55369 |
| Mailing Address |
200 University Ave E Saint Paul MN 55101-2507 |
| Practice Telephone | 6512912848 |
| Mailing Telephone | 6512912848 |
| Enumeration Date | 2007-12-27 |
| Last Update Date | 2019-12-13 |
| Authorized Official Name | PATRICK NOLAN (CFO) |
| Authorized Official Telephone | 6513123105 |
| Is Organization Subpart | Y |
| Parent Organization Name | GILLETTE CHILDRENS SPECIALTY HEALTHCARE |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | MN | Suppliers | |
| N | 332BC3200X |
Durable Medical Equipment & Medical Supplies Specialization: Customized Equipment |
MN | Suppliers | |
| N | 335E00000X | Prosthetic/Orthotic Supplier | MN | Suppliers | |
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 347487000 | 05 | |
| MN | BLUE CROSS | 1111HGI | 01 |
| Other Name | Type Code |
|---|---|
| Gillette Children's Specialty Healthcare- Grove Health | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427557867 | Gillette Children's Specialty Healthcare | Clinic/Center | 505 Paul Bunyan Dr Nw, Bemidji, MN 56601-2400 | 2018-02-11 |
| 1114267093 | Gillette Children's Specialty Healthcare | Clinic/Center | 12400 Whitewater Dr Ste 2030, Minnetonka, MN 55343-4159 | 2013-02-28 |
| 1598068819 | Gillette Children's Specialty Healthcare | Durable Medical Equipment & Medical Supplies | 1303 1st St S Ste 1, Willmar, MN 56201-3493 | 2010-12-08 |
| 1801109012 | Gillette Children's Specialty Healthcare | Prosthetic/Orthotic Supplier | 15860 Audubon Way, Baxter, MN 56401-6943 | 2010-07-16 |
| 1225119175 | Gillette Children's Specialty Healthcare | Clinic/Center | 200 East University Ave, St. Paul, MN 55101 | 2006-10-18 |
| 1891319943 | Gillette Children's Specialty Healthcare | Non-Pharmacy Dispensing Site | 200 University Ave E, Saint Paul, MN 55101-2507 | 2020-06-04 |
| 1235639113 | Gillette Children's Specialty Healthcare | Clinic/Center | 300 S Bruce St, Marshall, MN 56258-1934 | 2018-02-16 |
| 1528455128 | Gillette Children's Specialty Healthcare | Durable Medical Equipment & Medical Supplies | 1303 1st St S, Suite 1, Willmar, MN 56201-3492 | 2015-04-21 |
| 1215324983 | Gillette Children's Specialty Healthcare | Durable Medical Equipment & Medical Supplies | 2024 S 6th St, Brainerd, MN 56401-4529 | 2015-04-21 |
| 1194111724 | Gillette Children's Specialty Healthcare | Durable Medical Equipment & Medical Supplies | 300 S Bruce St, Marshall, MN 56258-1934 | 2015-04-10 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Gillette Children's Specialty Healthcare | 200 University Avenue East, St. Paul, MN 55101 |
| System for Award Management (SAM) Entities | GILLETTE CHILDREN'S SPECIALTY HEALTHCARE | 200 University Ave E, Saint Paul, MN 55101-2507 |
| Street Address |
9550 UPLAND LANE NORTH SUITE 220 |
| City | MAPLE GROVE |
| State | MN |
| Zip Code | 55369 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376144188 | Bonnie Rose Theis | Counselor | 24 3rd Ave Ne, Unit B, Osseo, MN 55369 | 2020-11-06 |
| 1356976328 | Kirollos Samir Hanna | Pharmacist | 14500 99th Ave N, Suite 0a030, Maple Grove, MN 55369 | 2020-03-10 |
| 1396395463 | Susan Osborne | Technician | 9240 Orchid Lane, Maple Grove, MN 55369 | 2019-09-19 |
| 1710537196 | Janis Langsdale | Technician | 11070 108 Avenue North, Maple Grove, MN 55369 | 2019-09-17 |
| 1043724552 | Tracey Wahlquist | Speech-Language Pathologist | 11100 86th Ave N, Maple Grove, MN 55369 | 2017-11-20 |
| 1154860005 | Kayla Uptagrafft | Specialist/Technologist | 9555 Upland Lane Norh, Maple Grove, MN 55369 | 2017-02-13 |
| 1750823324 | Jennifer Ranallo | Social Worker | 9600 Upland Ln N Ste 110, Maple Grove, MN 55369 | 2016-11-13 |
| 1558723999 | Debra Grace Boersma | Advanced Practice Midwife | 9825 Hospital Dr#205, Maple Grove, MN 55369 | 2016-03-24 |
| 1396129433 | Maple Grove Smiles Dentistry, PC | Dentist | 12775 Elm Creek Blvd N, Maple Grove, MN 55369 | 2015-07-18 |
| 1558755900 | Krista Newman | Counselor | 24 3rd St Nw, Unit B, Osseo, MN 55369 | 2015-03-24 |
| Find all providers in zip 55369 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548644750 | Natural Care Management, Pllc | Clinic/Center | 7181 Yucca Cir, Maple Grove, MN 55311-3351 | 2015-07-17 |
| 1356956163 | Med Cell Regenerate, LLC | Clinic/Center | 7373 Kirkwood Ct N Ste 110, Maple Grove, MN 55369-5211 | 2020-09-09 |
| 1841315165 | Fairview Clinics | Clinic/Center | 14500 99th Ave N, Ste 100, Maple Grove, MN 55369-4478 | 2007-03-20 |
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|---|---|---|---|---|
| 1245855162 | The Duluth Clinic Ltd | Clinic/Center | 1600 Miller Trunk Hwy Ste 1300, Duluth, MN 55811-5640 | 2020-06-16 |
| 1184250060 | Premise Health of Minnesota Medical P C | Clinic/Center | 1906 8th St Nw, Austin, MN 55912-2473 | 2020-03-23 |
| 1053952606 | Fairview Express Care | Clinic/Center | 2512 6th Street, Suite F105, Minneapolis, MN 55454-1401 | 2019-10-04 |
| 1730731464 | St Marys Regional Health Center | Clinic/Center | 1103 1st St E, Park Rapids, MN 56470 | 2019-07-12 |
| 1003478892 | The Duluth Clinic Ltd | Clinic/Center | 4289 Ugstad Rd, Hermantown, MN 55811-3615 | 2019-07-02 |
| 1073005856 | Arbor Integrative Behavioral Health | Clinic/Center | 1000 E 1st St Ste 105, Duluth, MN 55805-2297 | 2018-06-06 |
| 1689161077 | Chs Tennessee Medical P C | Clinic/Center | 701 Brooks Ave S, Thief River Falls, MN 56701-2757 | 2018-04-20 |
| 1427557867 | Gillette Children's Specialty Healthcare | Clinic/Center | 505 Paul Bunyan Dr Nw, Bemidji, MN 56601-2400 | 2018-02-11 |
| 1992224331 | Orthopedic & Sports Physical Therapy, Inc. | Clinic/Center | 322 N Tower Rd, Fergus Falls, MN 56537-1015 | 2017-09-18 |
| 1003339789 | Centracare Clinic | Clinic/Center | 2025 Stearns Way Ste 114, Saint Cloud, MN 56303 | 2017-07-25 |
| Find all providers with the same taxonomy | ||||
| City | MAPLE GROVE |
| Zip Code | 55369 |
Please comment or provide details below to improve the information on GILLETTE CHILDREN'S SPECIALTY HEALTHCARE.
| 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.