GILLETTE CHILDRENS SPECIALTY HEALTHCARE (NPI# 1760541700) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760541700 |
| Entity Type | Organization |
| Organization Name | GILLETTE CHILDRENS SPECIALTY HEALTHCARE |
| Practice Address |
435 Phalen Blvd Saint Paul MN 55130-5302 |
| Mailing Address |
200 University Ave E Saint Paul MN 55101-2507 |
| Practice Telephone | 6516369443 |
| Mailing Telephone | 6513252177 |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2019-12-13 |
| Authorized Official Name | PATRICK NOLAN (CFO) |
| Authorized Official Telephone | 6513123105 |
| Is Organization Subpart | Y |
| Parent Organization Name | GILLETTE CHILDREN'S SPECIALTY HEALTHCARE |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities | ||
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | MN | Suppliers | |
| N | 335E00000X | Prosthetic/Orthotic Supplier | MN | Suppliers | |
| Y | 332BC3200X |
Durable Medical Equipment & Medical Supplies Specialization: Customized Equipment |
MN | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 310980000 | 05 | |
| SD | 5521290 | 05 | |
| SD | 9163630 | 05 | |
| ND | 01267 | 05 | |
| IA | 0700813 | 05 | |
| MI | 498935487 | 05 | |
| ND | 51199 | 05 | |
| IA | 0520726 | 05 | |
| WI | 41683100 | 05 | |
| MN | 996047300 | 05 | |
| MN | 465410000 | 05 | |
| WI | 11003700 | 05 | |
| BLUE CROSS BLUE SHIELD | 1111HGI | 01 |
| Other Name | Type Code |
|---|---|
| Gillette Lifetime Specialty Healthcare | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740325885 | Gillette Childrens Specialty Healthcare | General Acute Care Hospital | 200 University Ave E, Saint Paul, MN 55101-2507 | 2007-02-20 |
| Street Address |
435 PHALEN BLVD |
| City | SAINT PAUL |
| State | MN |
| Zip Code | 55130-5302 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740720812 | Nicole Renee Hoisser | Nurse Practitioner | 435 Phalen Blvd, Saint Paul, MN 55130-5302 | 2017-03-08 |
| 1922548809 | Amy Jo Porter | Specialist | 435 Phalen Blvd, Saint Paul, MN 55130-5302 | 2017-02-27 |
| 1285186619 | Katherine Jonas | Physician Assistant | 435 Phalen Blvd, Saint Paul, MN 55130-5302 | 2016-11-02 |
| 1316491970 | Angela Kezar | Occupational Therapist | 435 Phalen Blvd, Saint Paul, MN 55130-5302 | 2016-08-11 |
| 1760833446 | Marie-pier Winters | Physical Therapist | 435 Phalen Blvd, Saint Paul, MN 55130-5302 | 2016-06-24 |
| 1376904698 | Michaelen Elise Sundstrom | Physical Therapist | 435 Phalen Blvd, Saint Paul, MN 55130-5302 | 2016-03-14 |
| 1932568524 | Lindsay Knight | Specialist/Technologist | 435 Phalen Blvd, Saint Paul, MN 55130-5302 | 2016-02-11 |
| 1134594310 | Dawn Babcock | Nurse Practitioner | 435 Phalen Blvd, Saint Paul, MN 55130-5302 | 2015-12-14 |
| 1750767158 | Leonardo E Candelario Perez | Psychologist | 435 Phalen Blvd, Saint Paul, MN 55130 | 2015-08-07 |
| 1487030490 | Clinton Mccullough | Specialist/Technologist | 435 Phalen Blvd, Saint Paul, MN 55130-5302 | 2015-08-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164904587 | Confident Care LLC | In Home Supportive Care | 1040 Arkwright Street, Saint Paul, MN 55130 | 2018-09-01 |
| 1881015253 | Lucas Bosco Wanga | Psychologist | 715 Edgerton Street, Merrick Community Services, St. Paul, MN 55130 | 2014-01-02 |
| 1174865570 | Sarang Patel | Internal Medicine | 401 Phalen Blvd # 41103d, Saint Paul, MN 55130 | 2013-03-23 |
| 1427394501 | Zongxee Lee | Registered Nurse | 1072 Payne Ave, St. Paul, MN 55130 | 2012-12-18 |
| 1740532753 | One Stop Medical Supply Inc | Durable Medical Equipment & Medical Supplies | 1049 Payne Ave Suite C, St Paul, MN 55130 | 2012-10-15 |
| 1689923997 | Alexis Simmons | Counselor | 402 University Ave East, Suite A-127, Saint Paul, MN 55130 | 2012-08-31 |
| 1689804064 | Group Health Plan, Inc. | Durable Medical Equipment & Medical Supplies | 537 Phalen Blvd, Saint Paul, MN 55130 | 2009-07-21 |
| 1477756534 | Chad Everett Christensen | Chiropractor | 1073 Payne Ave, Saint Paul, MN 55130 | 2007-06-07 |
| 1922219021 | Qwik Urgent Care Clinic | Family Medicine | 1239 Payne Avenue, Saint Paul, MN 55130 | 2007-05-24 |
| 1275743981 | Yia Vang | Technician | 1100 Arkwright St., St. Paul, MN 55130 | 2007-05-23 |
| Find all providers in zip 55130 | ||||
| Taxonomy Code | 332BC3200X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| Specialization | Customized Equipment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770913626 | Icare Optical, LLC | Durable Medical Equipment & Medical Supplies | 1001 Johnson Pkwy, Ste 271, Saint Paul, MN 55106-3474 | 2013-11-13 |
| 1053645929 | Consumers Medical Supply | Durable Medical Equipment & Medical Supplies | 619 Lafayette Rd N, 311, Saint Paul, MN 55130-4446 | 2009-09-25 |
| 1952545402 | Hearmore Hearing Aid Center | Durable Medical Equipment & Medical Supplies | 1445 White Bear Ave N, Saint Paul, MN 55106-2404 | 2009-04-28 |
| 1689600306 | Praxair Healthcare Services, Inc. | Durable Medical Equipment & Medical Supplies | 280 E Lafayette Frontage Rd, Saint Paul, MN 55107-1217 | 2006-06-24 |
| 1760727077 | The Low Vision Store | Durable Medical Equipment & Medical Supplies | 2200 University Ave W, Suite 200, Saint Paul, MN 55114-1839 | 2012-11-28 |
| 1730485228 | Heartland Medical Distribution, Lllp | Durable Medical Equipment & Medical Supplies | 1108 Howell St S, Saint Paul, MN 55116-2526 | 2011-02-01 |
| 1760618011 | Northland Foot and Ankle Specialists, P.C. | Durable Medical Equipment & Medical Supplies | 2221 Ford Pkwy, Suite 350, Saint Paul, MN 55116-3837 | 2009-06-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053975045 | Erin Michelle Shusta | Durable Medical Equipment & Medical Supplies | 8722 47th St Sw, Howard Lake, MN 55349-5203 | 2019-04-25 |
| 1538635248 | Baby's On Broadway | Durable Medical Equipment & Medical Supplies | 47 E Broadway, Little Falls, MN 56345-3046 | 2018-10-19 |
| 1104392398 | Fairview Health Services | Durable Medical Equipment & Medical Supplies | 1875 Woodwinds Dr Ste 150, Woodbury, MN 55125-2518 | 2018-10-16 |
| 1588167886 | Wes Utility Services Inc | Durable Medical Equipment & Medical Supplies | 1064 140th Ave, Ogilvie, MN 56358-3568 | 2018-03-13 |
| 1528579869 | Anybattery Inc | Durable Medical Equipment & Medical Supplies | 2605 160th St W Ste 116, Rosemount, MN 55068-1632 | 2017-10-13 |
| 1801315650 | North Star Podiatric Laboratories Inc. | Durable Medical Equipment & Medical Supplies | 7400 Lyndale Ave S Ste 160, Richfield, MN 55423-4142 | 2017-09-13 |
| 1053831941 | Chanhassen Family Dentistry Pa | Durable Medical Equipment & Medical Supplies | 8116 Mallory Ct, Chanhassen, MN 55317-8586 | 2017-06-22 |
| 1972040319 | William Edward Goldberg | Durable Medical Equipment & Medical Supplies | 1254 Robert St S, 1260 South Robert Street, West St Paul, MN 55118-2448 | 2017-01-24 |
| 1639622814 | Berkshire Construction Company | Durable Medical Equipment & Medical Supplies | 2605 Fernbrook Ln N Ste A, Plymouth, MN 55447-4745 | 2016-07-25 |
| 1730541830 | Waldoch Crafts, Inc. | Durable Medical Equipment & Medical Supplies | 13821 Lake Dr Ne, Forest Lake, MN 55025-9444 | 2016-03-28 |
| Find all providers with the same taxonomy | ||||
| City | SAINT PAUL |
| Zip Code | 55130 |
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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.