NEW KINGDOM PEDIATRICS LLC (NPI# 1760816045) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760816045 |
| Entity Type | Organization |
| Organization Name | NEW KINGDOM PEDIATRICS LLC |
| Practice Address |
6452 City West Pkwy Eden Prairie MN 55344-3245 |
| Practice Telephone | 9529990333 |
| Mailing Telephone | 9529990333 |
| Enumeration Date | 2013-08-22 |
| Last Update Date | 2013-08-22 |
| Authorized Official Name | ROBERT ZAJAC (CEO) |
| Authorized Official Telephone | 9524124229 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | 44503 | MN | Ambulatory Health Care Facilities |
| Street Address |
6452 CITY WEST PKWY |
| City | EDEN PRAIRIE |
| State | MN |
| Zip Code | 55344-3245 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578551636 | Robert John Zajac | Pediatrics | 6452 City West Pkwy, Eden Prairie, MN 55344-3245 | 2005-10-12 |
| 1407466436 | Amy Pedersen | Nurse Practitioner | 6452 City West Pkwy, Eden Prairie, MN 55344-3245 | 2020-08-04 |
| 1952928723 | Leah Marie Tasso | Nurse Practitioner | 6452 City West Pkwy, Eden Prairie, MN 55344-3245 | 2020-06-28 |
| 1134760903 | Nichole Kathleen Sorteberg | Nurse Practitioner | 6452 City West Pkwy, Eden Prairie, MN 55344-3245 | 2019-10-03 |
| 1285295626 | Quincee Lynn Macgibbon | Nurse Practitioner | 6452 City West Pkwy, Eden Prairie, MN 55344-3245 | 2019-06-26 |
| 1740776707 | Stacy Adair Woodard | Nurse Practitioner | 6452 City West Pkwy, Eden Prairie, MN 55344-3245 | 2018-07-02 |
| 1801304696 | Cynthia Lee Voigt | Nurse Practitioner | 6452 City West Pkwy, Eden Prairie, MN 55344 | 2018-01-16 |
| 1447772934 | Stephanie Augustin | Registered Nurse | 6452 City West Pkwy, Eden Prairie, MN 55344-3245 | 2017-07-17 |
| 1497277438 | Katie Ann Eagle | Nurse Practitioner | 6452 City West Pkwy, Eden Prairie, MN 55344-3245 | 2017-07-12 |
| 1144534140 | Katie L Seremet | Nurse Practitioner | 6452 City West Pkwy, Eden Prairie, MN 55344-3245 | 2010-08-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366000572 | Hekima Care Inc. | Case Management | 8725 Columbine Rd Unit 46026, Eden Prairie, MN 55344 | 2019-06-03 |
| 1528537768 | Smile Eden Prairie | Dentist | 6600 City W. Pkwy #315, Eden Prairie, MN 55344 | 2018-11-16 |
| 1215439781 | Angelo Scherer | Counselor | 11010 Prairie Lakes Drive Suite 350, Eden Prairie, MN 55344 | 2018-03-01 |
| 1497272678 | Matthew Lynn | Occupational Therapist | 431 Prairie Center Drive, Eden Prairie, MN 55344 | 2017-08-28 |
| 1184178956 | Eric R Barrett | Audiologist | Starkey Center for Excellence, 6700 Washington Ave S, Eden Prairie, MN 55344 | 2016-08-10 |
| 1609218676 | Nations Care Link | Nurse Practitioner | 11000 Praire Lakes Dr, Suite 600, Eden Praire, MN 55344 | 2013-07-19 |
| 1497020390 | Alixa Rx LLC | Pharmacy | 10132 West 76th St, Eden Prairie, MN 55344 | 2012-03-12 |
| 1831467331 | Eagle Ridge Academy | Local Education Agency (LEA) | 7255 Flying Cloud Drive, Eden Prairie, MN 55344 | 2011-12-12 |
| 1205154739 | Eden Prairie School District 272 | Local Education Agency (LEA) | 8100 School Road, Eden Prairie, MN 55344 | 2010-05-07 |
| 1992030613 | Spinal Health | Chiropractor | 12100 Singletree Ln #129, Eden Prairie, MN 55344 | 2009-10-14 |
| Find all providers in zip 55344 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013420561 | Rogers Memorial Hospital Inc | Clinic/Center | 6442 City West Pkwy Ste 200, Eden Prairie, MN 55344-3245 | 2017-11-07 |
| 1750781910 | Thomas J. Ratelle, Dc, Pllc | Clinic/Center | 800 Prairie Center Dr, Ste. 200, Eden Prairie, MN 55344-7328 | 2014-08-25 |
| 1154559136 | Fairview Health Services | Clinic/Center | 830 Prairie Center Dr, Ste 110, Eden Prairie, MN 55344-7301 | 2009-06-29 |
| 1508093063 | Chad Dockter Od Ltd | Clinic/Center | 8225 Flying Cloud Dr, Eden Prairie, MN 55344-5315 | 2009-06-11 |
| 1982630505 | Center for Natural Medicine Pa | Clinic/Center | 11800 Singletree Ln, Suite 310, Eden Prairie, MN 55344-5328 | 2006-06-24 |
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|---|---|---|---|---|
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| 1003434622 | Lost Lake Optical Company | Clinic/Center | 5240 Shady Island Cir, Mound, MN 55364-9222 | 2020-07-09 |
| 1811513310 | Prescribed By LLC | Clinic/Center | 701 Washington Ave N Ste 111-321, Minneapolis, MN 55401-2822 | 2020-06-19 |
| 1992320014 | Jtp Professional Service Corporation | Clinic/Center | 2038 Ford Pkwy # 444, Saint Paul, MN 55116-1931 | 2020-06-15 |
| 1689299125 | Altru Health System | Clinic/Center | 1st & Roosevelt, Karlstad, MN 56732 | 2020-06-10 |
| 1831710409 | Webmed LLC | Clinic/Center | 925 E Superior St Ste 113, Duluth, MN 55802-2253 | 2020-05-05 |
| 1073149779 | Functional Chiropractic Rehab, Pllc | Clinic/Center | 1901 Madison Ave Ste 120, Mankato, MN 56001-6267 | 2020-03-14 |
| 1225676067 | Liana Healthcare P.ll.c | Clinic/Center | 8348 Beard Rd, Bloomington, MN 55431-1028 | 2019-12-11 |
| 1245875293 | Fairview Clinics | Clinic/Center | 12912 Farnham Ave N, White Bear Lake, MN 55110-5929 | 2019-11-14 |
| 1275175242 | Hye-kyong Kim Therapy LLC | Clinic/Center | 1145 Grand Ave # 101, Saint Paul, MN 55105-2629 | 2019-10-11 |
| Find all providers with the same taxonomy | ||||
| City | EDEN PRAIRIE |
| Zip Code | 55344 |
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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.