WAYZATA CHILDREN'S CLINIC P.A. (NPI# 1023081577) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023081577 |
| Entity Type | Organization |
| Organization Name | WAYZATA CHILDREN'S CLINIC P.A. |
| Practice Address |
14001 Ridgedale Dr #100 Minnetonka MN 55305-1753 |
| Practice Telephone | 9524730211 |
| Practice Fax Number | 9524737908 |
| Mailing Telephone | 9524730211 |
| Mailing Fax Number | 9524737908 |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2017-04-05 |
| Authorized Official Name | MARTHA R. ENGELBREKT (PRESIDENT) |
| Authorized Official Telephone | 9524730211 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| Street Address |
14001 RIDGEDALE DR #100 |
| City | MINNETONKA |
| State | MN |
| Zip Code | 55305-1753 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740286400 | Susan Joyce Cushman | Obstetrics & Gynecology | 14001 Ridgedale Dr, Ste 200, Minnetonka, MN 55305-1753 | 2005-06-27 |
| 1306383609 | Kathryn Gestach | Physician Assistant | 14001 Ridgedale Dr, Suite 100, Minnetonka, MN 55305-1753 | 2017-01-24 |
| 1447610241 | Kayla Jean Schonhardt | Registered Nurse | 14001 Ridgedale Dr, Suite 100, Minnetonka, MN 55305-1753 | 2016-03-07 |
| 1639552136 | Advanced Care Chiropractic P.a. | Chiropractor | 14001 Ridgedale Dr, Suite 390, Minnetonka, MN 55305-1753 | 2015-07-01 |
| 1639599970 | Jessie Arnason | Pediatrics | 14001 Ridgedale Dr, #100, Minnetonka, MN 55305-1781 | 2014-04-25 |
| 1316383789 | Danielle Marie Thelen | Nurse Practitioner | 14001 Ridgedale Dr, #100, Minnetonka, MN 55305-1781 | 2013-05-13 |
| 1942645601 | Madeline Streitz Pokorney Goeden | Pediatrics | 14001 Ridgedale Dr, Suite 100, Minnetonka, MN 55305-1753 | 2013-05-07 |
| 1265779714 | Anna M Bennett | Specialist/Technologist, Other | 14001 Ridgedale Dr, Suite 200, Minnetonka, MN 55305-1753 | 2013-01-03 |
| 1346512639 | Ent & Sleep Clinics Minnesota LLC | Otolaryngology | 14001 Ridgedale Dr, Suite 330, Minnetonka, MN 55305-1753 | 2012-02-01 |
| 1255623203 | Advanced Care Chiropractic P.a. | Chiropractor | 14001 Ridgedale Dr, Suite 390, Minnetonka, MN 55305-1753 | 2011-05-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255948584 | Sober Living Connection | Substance Abuse Rehabilitation Facility | 11115 Minnetonka Blvd, Hopkins, MN 55305 | 2020-09-30 |
| 1649739103 | Gabriel Douglas Orem | Occupational Therapist | 10653 Waysata Blvd., Suite 200, Minnetonka, MN 55305 | 2019-03-14 |
| 1750863106 | Andrea Haglin | Counselor | 10505 Wayzata Blvd. Ste 101, Minnetonka, MN 55305 | 2018-09-02 |
| 1770934499 | Acme Transportation | Private Vehicle | 11356 Cedar Pointe Dr, Minnetonka, MN 55305 | 2016-06-23 |
| 1841641743 | Laine Cecily Hartwell Epp | Counselor | 1300 Wayzata Blvd., Ste. 400, Minnetonka, MN 55305 | 2016-06-22 |
| 1407217367 | Larissa Vados | Acupuncturist | 11654 Wayzata Blvd, Minnetonka, MN 55305 | 2016-03-18 |
| 1548658982 | Irene Grudsky | Contractor | 10550 Wayzata Blvd, Minnetonka, MN 55305 | 2015-01-08 |
| 1780093500 | Lalaine Arbuthnot Ortlieb | Counselor | 11900 Wayzata Blvd, Suite 100, Minnetonka, MN 55305 | 2014-08-06 |
| 1235472275 | Katherine Thistle Rivard | Dietitian, Registered | 11240 Cedar Pointe Drive North, Minnetonka, MN 55305 | 2013-03-28 |
| 1558633784 | Vickie Lynn Schaefer | Social Worker | 10505 Wayzata Blve Suite 101, Minnetonka, MN 55305 | 2012-02-03 |
| Find all providers in zip 55305 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| 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 Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275144164 | Sundus Sabrie | Pediatrics | 17705 Hutchins Dr Ste 250, Minnetonka, MN 55345-4103 | 2020-08-13 |
| 1770914095 | South Lake Clinic, Pa | Pediatrics | 17705 Hutchins Drive Suite 250, Minnetonka, MN 55345 | 2013-12-12 |
| 1043641368 | South Lake Clinic, Pa | Pediatrics | 17705 Hutchins Drive Suite, 250, Minnetonka, MN 55345 | 2013-12-12 |
| 1780015008 | South Lake Clinic, Pa | Pediatrics | 17705 Hutchins Drive, Suite 250, Minnetonka, MN 55345 | 2013-12-12 |
| 1235439548 | Crystal Singewald | Pediatrics | 17705 Hutchins Dr Ste 100, Minnetonka, MN 55345-4145 | 2010-11-02 |
| 1447480280 | Yana T. Nagle | Pediatrics | 17705 Hutchins Drive, Suite 101, South Lake Pediatrics, Minnetonka, MN 55345 | 2009-07-14 |
| 1417047879 | Daniel P Kohen | Pediatrics | 10505 Wayzata Blvd, Suite #200, Minnetonka, MN 55305-1502 | 2006-10-13 |
| 1063486595 | Burton Allan Benson Jr. | Pediatrics | 14001 Ridgedale Dr Ste 100, Minnetonka, MN 55305-1781 | 2006-02-13 |
| 1528030053 | Kelly Swearingen Lemieux | Pediatrics | 14001 Ridgedale Drive, #100, Minnetonka, MN 55305 | 2006-02-07 |
| 1942728936 | Shane Mcwhirter | Pediatrics | 14001 Ridgedale Dr Ste 100, Minnetonka, MN 55305-1781 | 2017-08-30 |
| Find all providers in MINNETONKA | ||||
| City | MINNETONKA |
| Zip Code | 55305 |
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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.