SPORTS ORTHOPEDIC ADVANCED REHABILITATION, LLC (NPI# 1780910802) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780910802 |
| Entity Type | Organization |
| Organization Name | SPORTS ORTHOPEDIC ADVANCED REHABILITATION, LLC |
| Practice Address |
4660 Slater Rd Ste 240 Eagan MN 55122 |
| Mailing Address |
4660 Slater Rd Ste 240 Eagan MN 55122-4047 |
| Practice Telephone | 9522233339 |
| Practice Fax Number | 9523141401 |
| Mailing Telephone | 9522233339 |
| Mailing Fax Number | 9523141401 |
| Enumeration Date | 2009-10-23 |
| Last Update Date | 2019-11-07 |
| Authorized Official Name | DR. TERESA L. GURIN (PRESIDENT) |
| Authorized Official Telephone | 9522233339 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208100000X | Physical Medicine & Rehabilitation | 39052 | MN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 1780910802 | 05 | |
| MN | MEDICARE PTAN | C05426 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4660 Slater Rd Ste 240, Eagan, MN 55122 | 9522233339 | 9523141401 |
| 825 Nicollet Mall, Suite 809, Minneapolis, MN 554022604 | 9522233339 | 9523141401 |
| Street Address |
4660 SLATER RD STE 240 |
| City | EAGAN |
| State | MN |
| Zip Code | 55122 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821046566 | Teresa Louise-keller Gurin | Physical Medicine & Rehabilitation | 4660 Slater Rd Ste 240, Eagan, MN 55122-4047 | 2006-05-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730651753 | Alvaro Jesus Jimenez Aguilar | Registered Nurse | 1764 Silver Bell Rd, Eagan, MN 55122 | 2019-01-02 |
| 1194213280 | Amherst H. Wilder Foundation | Lodging | Lincoln Place, 1997 Gold Trail, Eagan, MN 55122 | 2018-04-25 |
| 1831541168 | Mackenzie Lea Kerber | Counselor | 3410 Federal Dr Suite 101, Eagan, MN 55122 | 2016-07-11 |
| 1285010074 | Eagan Pointe Senior Living | Assisted Living Facility | 4232 Black Hawk Road, Eagan, MN 55122 | 2015-08-04 |
| 1700268828 | Kara Beth Rose | Specialist/Technologist | 4560 Cinnamon Ridge Trail, Eagan, MN 55122 | 2015-06-25 |
| 1558740803 | Samuel Johnson | Physician Assistant | 2901 Metro Drive, Suite 527, Bloomington, MN 55122 | 2015-05-20 |
| 1528451028 | Judi Ross Holistic Therapy, LLC | Marriage & Family Therapist | 4141 Old Sibley Memorial Highway, Eagan, MN 55122 | 2015-03-09 |
| 1447649637 | Leah Ruth Streitman | Physician Assistant | 3460 Washington Dr Ste 200, Eagan, MN 55122 | 2015-01-12 |
| 1518362193 | Cedar Valley Center for Child & Family Therapy | Preferred Provider Organization | 3460 Washington Dr., Suite 110, Eagan, MN 55122 | 2014-10-25 |
| 1316351703 | Wecare Dental of Eagan P.c | Clinic/Center | 1625 Lena Court Suite 100, Eagan, MN 55122 | 2014-06-13 |
| Find all providers in zip 55122 | ||||
| Taxonomy Code | 208100000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Physical Medicine & Rehabilitation |
| Physical medicine and rehabilitation, also referred to as rehabilitation medicine, is the medical specialty concerned with diagnosing, evaluating, and treating patients with physical disabilities. These disabilities may arise from conditions affecting the musculoskeletal system such as neck and back pain, sports injuries, or other painful conditions affecting the limbs, such as carpal tunnel syndrome. Alternatively, the disabilities may result from neurological trauma or disease such as spinal cord injury, head injury or stroke. A physician certified in physical medicine and rehabilitation is often called a physiatrist. The primary goal of the physiatrist is to achieve maximal restoration of physical, psychological, social and vocational function through comprehensive rehabilitation. Pain management is often an important part of the role of the physiatrist. For diagnosis and evaluation, a physiatrist may include the techniques of electromyography to supplement the standard history, physical, x-ray and laboratory examinations. The physiatrist has expertise in the appropriate use of therapeutic exercise, prosthetics (artificial limbs), orthotics and mechanical and electrical devices. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Physical Medicine and Rehabilitation, 2007. http://www.abpmr.org/. American Osteopathic Board of Physical Medicine and Rehabilitation, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Physical Medicine and Rehabilitation. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Physical Medicine and Rehabilitation. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821046566 | Teresa Louise-keller Gurin | Physical Medicine & Rehabilitation | 4660 Slater Rd Ste 240, Eagan, MN 55122-4047 | 2006-05-05 |
| 1124468962 | Brennan J Boettcher | Physical Medicine & Rehabilitation | 2620 Eagan Woods Dr Ste 100, Eagan, MN 55121 | 2013-06-25 |
| 1710040456 | Rehabilitation Consultants, Inc. | Physical Medicine & Rehabilitation | 880 Blue Gentian Rd, Suite 150, Eagan, MN 55121-1669 | 2006-12-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851931349 | Andrew J Will Md Pa | Physical Medicine & Rehabilitation | 1463 White Oak Dr, Chaska, MN 55318-2525 | 2020-01-13 |
| 1497225742 | Jessica Lynch | Physical Medicine & Rehabilitation | 2015 Hennepin Ave N, Glencoe, MN 55336-1446 | 2018-11-29 |
| 1306323514 | Peggy Golembeck | Physical Medicine & Rehabilitation | 6211 Alden Way Ne, Fridley, MN 55432-4824 | 2018-07-20 |
| 1225523970 | Burnsville Surgery Center, P.a. | Physical Medicine & Rehabilitation | 14551 County Road 11 Ste 110, Burnsville, MN 55337-4735 | 2018-06-26 |
| 1790291748 | Allied Physical Therapy LLC | Physical Medicine & Rehabilitation | 506 E Kenny Road, Suite 100, Saint Paul, MN 55130-4555 | 2017-12-28 |
| 1336655521 | Andrew J Will Md Pa | Physical Medicine & Rehabilitation | 14551 County Road 11 Ste 100, Burnsville, MN 55337-4799 | 2017-12-26 |
| 1336677855 | Matthew David Hodgden | Physical Medicine & Rehabilitation | 1522 N Riverfront Dr, Mankato, MN 56001 | 2017-05-29 |
| 1902264278 | Andrew Steiner | Physical Medicine & Rehabilitation | 1673 Interlaken Ct, Waconia, MN 55387-2200 | 2016-02-02 |
| 1841655156 | Summit Orthopedics, Ltd | Physical Medicine & Rehabilitation | 2800 Chicago Ave Ste 402, Minneapolis, MN 55407-1352 | 2015-12-31 |
| 1750797072 | Andrew J Will Md Pa | Physical Medicine & Rehabilitation | 7270 Forestview Ln N Ste 100, Maple Grove, MN 55369-5555 | 2014-07-08 |
| Find all providers with the same taxonomy | ||||
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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.