EAST METRO FAMILY PRACTICE, P.A. (NPI# 1104044692) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104044692 |
| Entity Type | Organization |
| Organization Name | EAST METRO FAMILY PRACTICE, P.A. |
| Other Organization Name | EAST METRO - MARYLAND |
| Practice Address |
911 Maryland Ave E Saint Paul MN 55106-2647 |
| Mailing Address |
2025 Sloan Pl Suite 35 Saint Paul MN 55117-2007 |
| Practice Telephone | 6517762719 |
| Practice Fax Number | 6517713978 |
| Mailing Telephone | 6517722077 |
| Mailing Fax Number | 6517721889 |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | PAUL BERRISFORD (CEO) |
| Authorized Official Telephone | 6517721572 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 1417 | MN | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| East Metro - Maryland | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831317320 | East Metro Family Practice, P.a. | Family Medicine | 2056 Woodlane Dr, Woodbury, MN 55125-2917 | 2007-04-23 |
| 1598983082 | East Metro Family Practice, P.a. | Family Medicine | 1540 Randolph Ave, Saint Paul, MN 55105-2535 | 2007-04-23 |
| 1013135508 | East Metro Family Practice, P.a. | Family Medicine | 2601 Centennial Dr, Suite 100, Saint Paul, MN 55109-3041 | 2007-04-23 |
| 1760600258 | East Metro Family Practice, P.a. | Family Medicine | 2980 Buckley Way, Inver Grove Heights, MN 55076-2017 | 2007-04-23 |
| 1679791156 | East Metro Family Practice, P.a. | Family Medicine | 234 Wentworth Ave E, West Saint Paul, MN 55118-3525 | 2007-04-23 |
| Street Address |
911 MARYLAND AVE E |
| City | SAINT PAUL |
| State | MN |
| Zip Code | 55106-2647 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215996087 | Carl Stephen Wallin | Dentist | 911 Maryland Ave E, Saint Paul, MN 55106-2647 | 2006-03-21 |
| 1306214648 | Ellen Catherine Ratts | Nurse Practitioner | 911 Maryland Ave E, Saint Paul, MN 55106-2647 | 2015-09-03 |
| 1861802001 | Kelly Barnes | Family Medicine | 911 Maryland Ave E, Saint Paul, MN 55106-2647 | 2014-04-28 |
| 1932362332 | Katherine L Kardell | Family Medicine | 911 Maryland Ave E, Saint Paul, MN 55106-2647 | 2008-07-07 |
| 1194924126 | Benjamin Reid Bowling | Dentist | 911 Maryland Ave E, Saint Paul, MN 55106-2647 | 2007-07-11 |
| 1538201280 | Family Healthservices Minnesota, P.a | Non-Pharmacy Dispensing Site | 911 Maryland Ave E, Saint Paul, MN 55106-2647 | 2007-02-12 |
| 1497855894 | Katharine June Walker | Physician Assistant | 911 Maryland Ave E, Saint Paul, MN 55106-2697 | 2006-09-25 |
| 1790796837 | Thomas L Lundsten | Family Medicine | 911 Maryland Ave E, Saint Paul, MN 55106-2697 | 2006-08-11 |
| 1144237801 | John P Barsanti | Family Medicine | 911 Maryland Ave E, Saint Paul, MN 55106-2647 | 2006-08-02 |
| 1215967146 | Tara Lee Kelly | Family Medicine | 911 Maryland Ave E, Saint Paul, MN 55106-2647 | 2006-07-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720692403 | Shoua Yang | Pharmacist | 1180 Arcade St., St. Paul, MN 55106 | 2020-09-01 |
| 1477196715 | The Doctors Medical Clinic, P.a. | Family Medicine | 1504 Whitebear Ave, St Paul, MN 55106 | 2019-10-18 |
| 1144870544 | Lucy Anne Claugherty | Technician | 975 Cook Ave E., St. Paul, MN 55106 | 2019-09-17 |
| 1326602756 | Leslie Neher | Student in an Organized Health Care Education/Training Program | 1414 Maryland Avenue East, St. Paul, MN 55106 | 2019-05-01 |
| 1841758851 | Susan Janine Ferrell | Dental Hygienist | East Side Dental, 895 East 7th Street, St Paul, MN 55106 | 2019-03-08 |
| 1811465271 | Care Plus Hha Inc | Home Health | 1299 Arcade Street, Ste 100, St. Paul, MN 55106 | 2018-11-05 |
| 1033696760 | Strong Tower Health | Clinical Nurse Specialist | 1686 Suburban Ave, St Paul, MN 55106 | 2018-07-25 |
| 1861978439 | William Warmka | Physical Therapist | 1385 Phalen Blvd, St. Paul, MN 55106 | 2018-07-17 |
| 1902392111 | Chaffee Dialysis LLC | Clinic/Center | 862 Arcade St, Saint Paul, MN 55106 | 2018-07-11 |
| 1922594217 | Vangneng Xiong | Marriage & Family Therapist | 1299 Arcade St Ste 202, Saint Paul, MN 55106 | 2018-07-10 |
| Find all providers in zip 55106 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457889420 | Thanh Phung | Family Medicine | 2155 Ford Pkwy Ste A, Saint Paul, MN 55116-2799 | 2017-06-02 |
| 1518338268 | Northstar Professional Services | Family Medicine | 924 Rice St, Saint Paul, MN 55117-4987 | 2015-10-07 |
| 1386064111 | Laura Giegler | Family Medicine | 1983 Sloan Pl Ste 1, Saint Paul, MN 55117 | 2014-04-19 |
| 1306287719 | John Gordon Faughnan | Family Medicine | 1660 Stanford Ave, Saint Paul, MN 55105-2038 | 2013-07-13 |
| 1194041277 | Mark William Eaton | Family Medicine | 333 Smith Ave N # Ms 60202, Saint Paul, MN 55102-2344 | 2010-04-14 |
| 1326277815 | Branden James Pfefferkorn | Family Medicine | 2004 Ford Pkwy # Ms 35300a, Saint Paul, MN 55116-1931 | 2009-07-07 |
| 1780812651 | James Edward Hougas IIi | Family Medicine | Ump Phalen Village Clinic, 1414 Maryland Ave E, Saint Paul, MN 55106 | 2009-06-30 |
| 1871748509 | Deborah Lee Wexler | Family Medicine | 1573 Selby Ave, Suite 234, Saint Paul, MN 55104-6293 | 2008-11-21 |
| 1124206677 | Family Healthservices Minnesota, P.a. | Family Medicine | 2025 Sloan Pl, Suite 35, Saint Paul, MN 55117-2007 | 2008-02-07 |
| 1174703805 | Family Healthservices Minnesota, P.a. Dba Entira Family Clinics | Family Medicine | 1385 Phalen Boulevard, Saint Paul, MN 55106 | 2007-11-09 |
| Find all providers in SAINT PAUL | ||||
| City | SAINT PAUL |
| Zip Code | 55106 |
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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.