NICOLE MARIE RODDY (NPI# 1760521603) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760521603 |
| Entity Type | Individual |
| Full Name | NICOLE MARIE RODDY |
| Other Name | NICOLE MARIE JASKOWIAK |
| Practice Address |
911 Northland Dr Princeton MN 55371-2172 |
| Mailing Address |
7917 Prairie Creek Ln Ne Otsego MN 55330-4538 |
| Practice Telephone | 7633891313 |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225400000X | Rehabilitation Practitioner | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215550439 | Nicole Leigh Roddy | Optometrist | 3601 The Vanderbilt Clinic, Nashville, TN 37232-0025 | 2020-05-21 |
| Street Address |
911 NORTHLAND DR |
| City | PRINCETON |
| State | MN |
| Zip Code | 55371-2172 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922085299 | Fairview Health Services | Pathology | 911 Northland Dr, Princeton, MN 55371-2172 | 2005-12-28 |
| 1912515388 | Fairview Express Care | General Practice | 911 Northland Dr, Princeton, MN 55371-2172 | 2020-07-21 |
| 1780226142 | Paul Moench | Physical Therapist | 911 Northland Dr, Princeton, MN 55371-2172 | 2019-10-17 |
| 1730652512 | Nicole Burrington | Speech-Language Pathologist | 911 Northland Dr, Princeton, MN 55371-2172 | 2019-01-04 |
| 1972015550 | Morgan Taubel | Dietitian, Registered | 911 Northland Dr, Princeton, MN 55371-2172 | 2017-11-03 |
| 1457871956 | Sara Jesse Gleason | Physical Therapist | 911 Northland Dr, Princeton, MN 55371-2172 | 2017-06-26 |
| 1952779266 | Fairview Health Services | Family Medicine | 911 Northland Dr, Princeton, MN 55371-2172 | 2015-09-03 |
| 1376929547 | Dominique Meyer | Nurse Practitioner | 911 Northland Dr, Princeton, MN 55371-2172 | 2015-08-10 |
| 1841673647 | Fairview Health Services | Family Medicine | 911 Northland Dr, Princeton, MN 55371-2172 | 2015-06-30 |
| 1013399112 | Breanna Peterson | Emergency Medicine | 911 Northland Dr, Princeton, MN 55371 | 2015-06-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053962530 | Monica Gail Broten | Technician | 30840 Tiger Street Nw, Princeton, MN 55371 | 2019-09-25 |
| 1215349584 | Stephen Destefano | Pharmacist | 31419 131st Street, Princeton, MN 55371 | 2014-05-21 |
| 1164798948 | Andrew Sudbeck | Counselor | 101 18th Avenue North, Princeton, MN 55371 | 2012-03-27 |
| 1073804803 | Sterling Pointe Senior Living LLC | Assisted Living Facility | 1250 Northland Drive, Princeton, MN 55371 | 2011-04-27 |
| 1568752533 | Rum River Health Services, Inc. | Substance Abuse Rehabilitation Facility | 3079 90th Avenue, Princeton, MN 55371 | 2011-04-12 |
| 1780989038 | Dr. Kynan Westermeyer, Dds, Pllc | Clinic/Center | 404 1st St. N, Princeton, MN 55371 | 2011-01-18 |
| 1275788085 | Cody James Leff | Pharmacist | 1100 11th Avenue South, Princeton, MN 55371 | 2008-11-20 |
| 1164679213 | Rum River Health Services, Inc | Substance Abuse Rehabilitation Facility | 1101 N 5th St, Princeton, MN 55371 | 2008-08-20 |
| 1801059639 | Rum River Health Services, Inc | Substance Abuse Rehabilitation Facility | 1506 1st Street, Princeton, MN 55371 | 2008-07-02 |
| 1497940928 | James Michael Mandt | Pharmacist | 911 Northland Drive, Fairview Northland Medical Center, Princeton, MN 55371 | 2007-09-07 |
| Find all providers in zip 55371 | ||||
| Taxonomy Code | 225400000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Rehabilitation Practitioner |
| A health care practitioner who trains or retrains individuals disabled by disease or injury to help them attain their maximum functional capacity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568501492 | Anthony David Artisensi-skime | Rehabilitation Practitioner | 911 Northland Dr, Princeton, MN 55371-2172 | 2007-02-06 |
| 1427197375 | Joseph Kelley | Rehabilitation Practitioner | 911 Northland Dr, Princeton, MN 55371-2172 | 2007-02-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629615612 | Livelife Therapy Solutions | Rehabilitation Practitioner | 8100 Penn Ave S Ste 137, Bloomington, MN 55431-1325 | 2019-12-09 |
| 1962067611 | Connor Hanson | Rehabilitation Practitioner | 718 1st Ave Nw, New Brighton, MN 55112-6809 | 2019-05-08 |
| 1780963355 | Center for Primary Care and Rehabilitation, Pa | Rehabilitation Practitioner | 880 Blue Gentian Rd Ste 165, Eagan, MN 55121-1772 | 2011-08-12 |
| 1518192756 | David Michael Noren | Rehabilitation Practitioner | 521 Broadway Ave N, Braham, MN 55006 | 2009-05-18 |
| 1972764454 | Laura Lynn Kirlin | Rehabilitation Practitioner | 515 Bridge St. East, Park Rapids, MN 56470-1810 | 2008-06-18 |
| 1801084140 | Anthony Kroll | Rehabilitation Practitioner | 3609 White Bear Ave N, Suite #202, White Bear Lake, MN 55110-4466 | 2007-10-11 |
| 1609906734 | Paul Daniel Nistler | Rehabilitation Practitioner | 722 15th Street Ne, Bemidji, MN 56601 | 2007-03-07 |
| 1881747483 | Richard Marquardt | Rehabilitation Practitioner | Upper Mississippi Mental Health Center, 120 N Main Street, Park Rapids, MN 56470 | 2007-01-19 |
| 1346327004 | Shawn D. Anderson | Rehabilitation Practitioner | 515 Bridge St, Park Rapids, MN 56470-1210 | 2006-11-01 |
| 1639131279 | Samuel Fedo | Rehabilitation Practitioner | 501 E Nicollet Blvd, Suite 100, Burnsville, MN 55337-6732 | 2006-04-06 |
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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.