CEDAR RIVERSIDE PEOPLE'S CENTER (NPI# 1780133983) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780133983 |
| Entity Type | Organization |
| Organization Name | CEDAR RIVERSIDE PEOPLE'S CENTER |
| Other Organization Name | WELLSTONE DENTAL CLINIC |
| Practice Address |
3328 Elliot Ave S Minneapolis MN 55407-2125 |
| Mailing Address |
425 20th Ave S Minneapolis MN 55454-4400 |
| Practice Telephone | 6123324973 |
| Mailing Telephone | 6123324973 |
| Enumeration Date | 2016-09-28 |
| Last Update Date | 2016-09-28 |
| Authorized Official Name | SAHRA NOOR (CEO) |
| Authorized Official Telephone | 6123324973 |
| Authorized Official Credential | CEO |
| Is Organization Subpart | Y |
| Parent Organization Name | CEDAR RIVERSIDE PEOPLE'S CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QD0000X |
Clinic/Center Specialization: Dental |
MN | Ambulatory Health Care Facilities | |
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
MN | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Wellstone Dental Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700237708 | Cedar Riverside People's Center | Clinic/Center | 3328 Elliot Ave, Minneapolis, MN 55407-2125 | 2016-06-30 |
| 1851695514 | Cedar Riverside People's Center | Family Medicine | 2425 Chicago Avenue, Minneapolis, MN 55404-3845 | 2011-01-10 |
| 1871809152 | Cedar Riverside People's Center | Dentist | 3152 Minnehaha Avenue, Minneapolis, MN 55406-1934 | 2010-08-25 |
| 1285952606 | Cedar Riverside People's Center | Clinic/Center | 2219 Chicago Ave, Minneapolis, MN 55404-3842 | 2010-05-10 |
| 1548340813 | Cedar Riverside People's Center | Clinic/Center | 425 20th Avenue South, Minneapolis, MN 55454-4400 | 2006-10-17 |
| 1942759717 | Cedar Riverside People's Center | Clinic/Center | 425 20th Ave S, Minneapolis, MN 55454-4400 | 2016-09-22 |
| 1124472402 | Cedar Riverside People's Center | Clinic/Center | 425 20th Ave S, Minneapolis, MN 55454-4400 | 2016-04-22 |
| Street Address |
3328 ELLIOT AVE S |
| City | MINNEAPOLIS |
| State | MN |
| Zip Code | 55407-2125 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720644057 | Amana Home Care | Home Health | 2833 13th Ave S Suite 118, Minneapolis, MN 55407 | 2019-05-13 |
| 1356802979 | Aaron Randy Pickrel | Student in an Organized Health Care Education/Training Program | 2800 Chicago Avenue, #250, Minneapolis, MN 55407 | 2019-03-27 |
| 1053881631 | Naimo Abdisalam | Registered Nurse | 1229 East Lake Street, Minneapolis, MN 55407 | 2018-11-27 |
| 1437639614 | Kelly Usitalo | Nurse Practitioner | 913 E 26th Street, Piper Building Suite 401, Minneapolis, MN 55407 | 2018-08-17 |
| 1952880346 | Allison Hall | Internal Medicine | Minneapolis Heart Institute, 920 E 28 St. #300, Minneapolis, MN 55407 | 2018-08-07 |
| 1780176370 | Rebekah Sand | Physical Therapist | 2800 Chicage Avenue S, Suite 102, Minneapolis, MN 55407 | 2018-05-31 |
| 1417448663 | Vivian T.c. Liu | Student in an Organized Health Care Education/Training Program | 2020 E 28th Street, Suite 104, Minneapolis, MN 55407 | 2018-05-23 |
| 1053802397 | Isuroon | Counselor | 1600 East Lake Street Suite 1, Minneapolis, Mpls, MN 55407 | 2018-05-22 |
| 1154811404 | Mohamed Mukhtar Ali | Dentist | 4700 Cedar Ave S, Minneapolis, MN 55407 | 2018-05-12 |
| 1396254280 | Erin Elizabeth Casper | Registered Nurse | 3621 Oakland Ave, Minneapolis, MN 55407 | 2017-09-25 |
| Find all providers in zip 55407 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760949168 | Indian Health Board of Minneapolis, Inc | Clinic/Center | 2101 Minnehaha Avenue South, Minneapolis, MN 55404-3107 | 2019-02-22 |
| 1891266862 | Hennepin County | Clinic/Center | 41 N 12th St., Minneapolis, MN 55403-1325 | 2018-12-17 |
| 1700357779 | Hennepin County | Clinic/Center | 2211 Clinton Ave, Minneapolis, MN 55404-3656 | 2018-12-17 |
| 1487125597 | Hennepin County | Clinic/Center | 215 S 8th St, Minneapolis, MN 55402-2803 | 2018-12-16 |
| 1992276000 | Hennepin County | Clinic/Center | 2740 1st Ave S, Minneapolis, MN 55408-1611 | 2018-12-16 |
| 1841761954 | Hennepin County | Clinic/Center | 3111 First Ave. So., Minneapolis, MN 55408-2055 | 2018-12-16 |
| 1528539624 | Hennepin County | Clinic/Center | 740 East 17th Street, Minneapolis, MN 55404-1601 | 2018-12-16 |
| 1700237708 | Cedar Riverside People's Center | Clinic/Center | 3328 Elliot Ave, Minneapolis, MN 55407-2125 | 2016-06-30 |
| 1083083752 | Hennepin County | Clinic/Center | 1015 4th Ave N, Suite 201, Minneapolis, MN 55405-1189 | 2015-09-23 |
| 1285952606 | Cedar Riverside People's Center | Clinic/Center | 2219 Chicago Ave, Minneapolis, MN 55404-3842 | 2010-05-10 |
| Find all providers in MINNEAPOLIS | ||||
| City | MINNEAPOLIS |
| Zip Code | 55407 |
Please comment or provide details below to improve the information on CEDAR RIVERSIDE PEOPLE'S CENTER.
| 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.