PARK NICOLLET METHODIST HOSPITAL (NPI# 1942585286) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942585286 |
| Entity Type | Organization |
| Organization Name | PARK NICOLLET METHODIST HOSPITAL |
| Other Organization Name | PARK NICOLLET MELROSE CENTER |
| Practice Address |
3525 Monterey Dr St Louis Park MN 55416-5275 |
| Mailing Address |
Po Box 1488 Minneapolis MN 55480-1488 |
| Practice Telephone | 9529931990 |
| Practice Fax Number | 9529931980 |
| Mailing Telephone | 9529931990 |
| Mailing Fax Number | 9529931980 |
| Enumeration Date | 2011-10-19 |
| Last Update Date | 2019-09-09 |
| Authorized Official Name | MS. TRICIA L DEGE (SR VICE PRESIDENT, CFO) |
| Authorized Official Telephone | 9528835121 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282N00000X | General Acute Care Hospital | 350048 | MN | Hospitals |
| Other Name | Type Code |
|---|---|
| Park Nicollet Melrose Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649827973 | Park Nicollet Methodist Hospital | Clinic/Center | 14050 Fairview Dr, Burnsville, MN 55337-5713 | 2019-08-21 |
| 1689112898 | Park Nicollet Methodist Hospital | Pharmacy | 6500 Excelsior Blvd, St Louis Park, MN 55426-4702 | 2017-02-08 |
| 1174980692 | Park Nicollet Methodist Hospital | General Acute Care Hospital | 15800 95th Ave N, Maple Grove, MN 55369-4400 | 2016-01-28 |
| 1245615772 | Park Nicollet Methodist Hospital | General Acute Care Hospital | 6500 Excelsior Blvd, St Louis Park, MN 55426-4702 | 2015-07-27 |
| 1194113217 | Park Nicollet Methodist Hospital | General Acute Care Hospital | 3900 Park Nicollet Blvd, St Louis Park, MN 55416-2503 | 2014-12-23 |
| 1578717336 | Park Nicollet Methodist Hospital | Community Based Residential Treatment Facility, Mental Illness | 3525 Monterey Dr, St Louis Park, MN 55416-5275 | 2008-11-06 |
| 1942424742 | Park Nicollet Methodist Hospital | Pharmacy | 6500 Excelsior Blvd, St Louis Park, MN 55426-4702 | 2007-04-12 |
| 1255478798 | Park Nicollet Methodist Hospital | Durable Medical Equipment & Medical Supplies | 6500 Excelsior Blvd, St Louis Park, MN 55426 | 2007-02-01 |
| 1083622047 | Park Nicollet Methodist Hospital | Anesthesiology | 6500 Excelsior Blvd, St Louis Park, MN 55426 | 2006-08-04 |
| 1447201421 | Park Nicollet Methodist Hospital | Home Health | 6500 Excelsior Blvd, St Louis Park, MN 55426 | 2006-05-13 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | PARK NICOLLET METHODIST HOSPITAL | 6500 Excelsior Blvd, Saint Louis Park, MN 55426-4702 |
| Street Address |
3525 MONTEREY DR |
| City | ST LOUIS PARK |
| State | MN |
| Zip Code | 55416-5275 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275519563 | Deborah Mangham | Family Medicine | 3525 Monterey Dr, St Louis Park, MN 55416-5275 | 2005-12-19 |
| 1003440371 | Samantha Marie Slinger | Occupational Therapist | 3525 Monterey Dr, St Louis Park, MN 55416-5275 | 2020-02-26 |
| 1528603412 | Kelli Lynn Jones | Dietitian, Registered | 3525 Monterey Dr, St Louis Park, MN 55416-5275 | 2019-11-14 |
| 1558919068 | Lucy Ramquist | Dietitian, Registered | 3525 Monterey Dr, St Louis Park, MN 55416-5275 | 2019-08-28 |
| 1174170146 | Miranda Larson | Dietitian, Registered | 3525 Monterey Dr, St Louis Park, MN 55416-5275 | 2019-08-23 |
| 1467014043 | Kendra Rose Johnson | Occupational Therapist | 3525 Monterey Dr, St Louis Park, MN 55416-5275 | 2019-07-03 |
| 1669952180 | Hannah Paruzynski | Dietitian, Registered | 3525 Monterey Dr, St Louis Park, MN 55416 | 2018-08-14 |
| 1881114056 | Kaitlin Lezcano Lytle | Counselor | 3525 Monterey Dr, St Louis Park, MN 55416-5275 | 2017-06-20 |
| 1497283253 | John Leland Mckinley | Nurse Practitioner | 3525 Monterey Dr, St Louis Park, MN 55416 | 2017-05-24 |
| 1417483744 | Kayla Joy Muckenhirn | Occupational Therapist | 3525 Monterey Dr, St Louis Park, MN 55416-5275 | 2017-05-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639711492 | Ismahan Abdirahman Mohamed | Psychologist | 4236 Parkglen Rd, St Louis Park, MN 55416 | 2019-10-14 |
| 1598307860 | Ayman Abulaziz Mohamed | Counselor | 4326 Park Glen Rd, St Louis Park, MN 55416 | 2019-10-08 |
| 1831758929 | Ally Group Homes LLC | Assisted Living Facility | 2944 Princeton Ave South, Saint Louis Park, MN 55416 | 2019-06-11 |
| 1609371525 | Heather Margaret Flatgard | Chiropractor | 5407 Excelsior Blvd Ste D, St Louis Park, MN 55416 | 2018-03-25 |
| 1942702394 | Polaris Pharmacy Services of Minnesota, LLC | Pharmacy | 4220 Park Glen Road, St. Louis Park, MN 55416 | 2018-03-01 |
| 1316469760 | Evert Ray Boyd | Psychologist | 3200 Highway 100 S., Groves Academy, St Louis Park, MN 55416 | 2017-07-07 |
| 1861941684 | Amanda Marie Tapper | Marriage & Family Therapist | 5407 Excelsior Blvd, Suite B, St Louis Park, MN 55416 | 2016-09-22 |
| 1326410416 | Clear Health Chiropractic LLC | Chiropractor | 5614 W 36th St, St. Louis Park, MN 55416 | 2015-10-28 |
| 1568897833 | Kay Elizabeth Lichtenberger | Physical Therapist | 4415 W 36.5 St, St. Louis Park, MN 55416 | 2013-09-05 |
| 1710221510 | Aaron Christopher Oppelt | Counselor | 1665 Utica Ave South - Suite 100, Saint Louis Park, MN 55416 | 2012-11-16 |
| Find all providers in zip 55416 | ||||
| Taxonomy Code | 282N00000X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245615772 | Park Nicollet Methodist Hospital | General Acute Care Hospital | 6500 Excelsior Blvd, St Louis Park, MN 55426-4702 | 2015-07-27 |
| 1194113217 | Park Nicollet Methodist Hospital | General Acute Care Hospital | 3900 Park Nicollet Blvd, St Louis Park, MN 55416-2503 | 2014-12-23 |
| 1114278876 | Joseph Stephen Henefield | General Acute Care Hospital | 6500 Excelsior Blvd, St Louis Park, MN 55426-4702 | 2012-09-20 |
| 1104136142 | Park Nicollet- Methodist Hospital | General Acute Care Hospital | 6500 Excelsior Blvd, St Louis Park, MN 55426-4702 | 2010-10-08 |
| 1649220724 | Park Nicollet Methodist Hospital | General Acute Care Hospital | 6500 Excelsior Blvd, St Louis Park, MN 55426 | 2006-05-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811372360 | Karin Costin | General Acute Care Hospital | 803 E 28th St, Minneapolis, MN 55407 | 2015-07-27 |
| 1619317070 | Allegheny General Hospital | General Acute Care Hospital | 724 4th St Sw, Rochester, MN 55902-2913 | 2013-07-01 |
| 1003196361 | Fairview | General Acute Care Hospital | 21282 Inspiration Ct, Lakeville, MN 55044-6027 | 2011-08-18 |
| 1356652481 | Spectrum Health | General Acute Care Hospital | 25850 Brolin Beach Rd, Detroit Lakes, MN 56501-7978 | 2010-06-23 |
| 1093960742 | Fairview Health Services | General Acute Care Hospital | 13017 Lakeview Dr, Burnsville, MN 55337-3857 | 2008-11-22 |
| 1144477282 | Allina Home Care Hospice and Palliative Care | General Acute Care Hospital | 1055 Westgate Dr. Suite 100, St. Paul, MN 55114-1451 | 2008-08-20 |
| 1104029388 | Shannon Carl Nelson | General Acute Care Hospital | Highway 1 Box 497, Red Lake, MN 56671 | 2007-06-06 |
| 1356559983 | Rtgmedical | General Acute Care Hospital | 2186 Baneberry Way W, Chanhassen, MN 55317 | 2007-05-18 |
| 1730232307 | Jack Ramon Lees | General Acute Care Hospital | 2146 Lemay Lake Dr, Mendota Heights, MN 55120-1183 | 2007-01-18 |
| 1245349257 | Russell Vincent Luepker | General Acute Care Hospital | 1300 S 2nd St, Suite 300, Minneapolis, MN 55454-1075 | 2006-08-30 |
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| City | ST LOUIS PARK |
| Zip Code | 55416 |
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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.