OMNI MEDICAL CENTER PLLC (NPI# 1851991079) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851991079 |
| Entity Type | Organization |
| Organization Name | OMNI MEDICAL CENTER PLLC |
| Practice Address |
935 Wayzata Blvd E Ste 200 Wayzata MN 55391-2513 |
| Practice Telephone | 7635594500 |
| Practice Fax Number | 7635591733 |
| Mailing Telephone | 7635594500 |
| Mailing Fax Number | 7635591733 |
| Enumeration Date | 2020-10-27 |
| Last Update Date | 2020-10-27 |
| Authorized Official Name | DR. JOHN A NESS (CEO) |
| Authorized Official Telephone | 7635594500 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
Allopathic & Osteopathic Physicians | ||
| Y | 207YX0905X |
Otolaryngology Specialization: Otolaryngology/Facial Plastic Surgery |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Omni Cosmetic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659845659 | Omni Medical Center Pllc | Plastic Surgery | 935 Wayzata Blvd E Ste 200, Wayzata, MN 55391-2513 | 2019-01-14 |
| Street Address |
935 WAYZATA BLVD E STE 200 |
| City | WAYZATA |
| State | MN |
| Zip Code | 55391-2513 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124046933 | John A Ness | Surgery | 935 Wayzata Blvd E Ste 200, Wayzata, MN 55391-2513 | 2006-07-18 |
| 1003453515 | Omni Facial Plastic Surgery | Plastic Surgery | 935 Wayzata Blvd E Ste 200, Wayzata, MN 55391-2513 | 2019-12-03 |
| 1659845659 | Omni Medical Center Pllc | Plastic Surgery | 935 Wayzata Blvd E Ste 200, Wayzata, MN 55391-2513 | 2019-01-14 |
| 1558688366 | Bryan Nicholas Rolfes | Otolaryngology | 935 Wayzata Blvd E Ste 200, Wayzata, MN 55391-2513 | 2010-05-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790386456 | Alexandra Lloyd Conroy | Counselor | 3227 Lake Shore Boulevard, Minnetonka, MN 55391 | 2020-11-07 |
| 1417579178 | Kate Anne Schroeder | Behavioral Analyst | 901 Twelve Oaks Center Drive Suite 934, Wayzata, MN 55391 | 2020-05-15 |
| 1467940478 | Tyler Michael Knutson | Chiropractor | 1421 E Wayzata Blvd, Wayzata, MN 55391 | 2018-04-25 |
| 1427552025 | Emma Nadler, L.L.C. | Counselor | 700 Twelve Oaks Center Dr. #263, Wayzata, MN 55391 | 2018-03-20 |
| 1730687757 | Global Home Care Inc | Home Health | 1001 Twelve Oaks Center Drive, Suite 1018, Wayzata, MN 55391 | 2018-01-24 |
| 1205362472 | Oraphanh Vongpheth Smith | Registered Nurse | 801 Twelve Oaks Center Drive, Suite 822, Wayzata, MN 55391 | 2017-05-10 |
| 1386189272 | Wayzata Endodontics, P.a. | Dentist | 101 Lake Street West, Suite 100, Wayzata, MN 55391 | 2016-12-30 |
| 1952763351 | Watershed Psychological Services | Clinic/Center | 4255 Pheasant Ridge Drive, Suite 412, Blaine, MN 55391 | 2016-03-24 |
| 1477923571 | Robert J. Floren | Marriage & Family Therapist | 801 Twelve Oaks Center Dr Ste 816a, Wayzata, MN 55391 | 2015-10-01 |
| 1194101055 | Bruce Martinson Family & Cosmetic Dentistry | Dentist | 317 E Wayzata Blvd, Wayzata, MN 55391 | 2015-08-03 |
| Find all providers in zip 55391 | ||||
| Taxonomy Code | 207YX0905X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Otolaryngology/Facial Plastic Surgery |
| An otolaryngologist who specializes in the diagnosis and surgical treatment of head and neck conditions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558688366 | Bryan Nicholas Rolfes | Otolaryngology | 935 Wayzata Blvd E Ste 200, Wayzata, MN 55391-2513 | 2010-05-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477782738 | William Douglas Richards | Otolaryngology | 111 17th Ave E Ste 1, Alexandria, MN 56308-0057 | 2009-07-08 |
| 1609035781 | John Luther Boone | Otolaryngology | 6525 France Ave S Ste 325, Edina, MN 55435-2187 | 2008-06-04 |
| 1396181483 | Fareeda Taher Nazer Hussain | Otolaryngology | 1025 Marsh St, Mankato, MN 56001 | 2013-05-15 |
| 1730450297 | Prischmann Facial Plastic Surgery, Pllc | Otolaryngology | 5201 Eden Ave, Suite 170, Edina, MN 55436-2316 | 2012-01-15 |
| 1407947518 | Gary Edwin Schnitker | Otolaryngology | 7300 France Ave S, Suite #100, Edina, MN 55435-4525 | 2006-09-27 |
| 1992795058 | Ilya Perepelitsyn | Otolaryngology | 2211 Park Ave, Minneapolis, MN 55404-3711 | 2005-10-28 |
Please comment or provide details below to improve the information on OMNI MEDICAL CENTER PLLC.
| 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.