NICHKAMON UDOMLARP (NPI# 1194015396) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194015396 |
| Entity Type | Individual |
| Full Name | NICHKAMON UDOMLARP |
| Practice Address |
1675 Southdale Ctr 1675 Southdale Center Edina MN 55435-7015 |
| Practice Telephone | 9529223600 |
| Practice Fax Number | 9529223600 |
| Mailing Telephone | 9529223600 |
| Mailing Fax Number | 9529223600 |
| Enumeration Date | 2011-04-09 |
| Last Update Date | 2011-04-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | 708013939 | MN | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
1675 SOUTHDALE CTR 1675 SOUTHDALE CENTER |
| City | EDINA |
| State | MN |
| Zip Code | 55435-7015 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821388026 | Chollada Morpan Phan | Massage Therapist | 1675 Southdale Ctr, Edina, MN 55435-7015 | 2011-04-09 |
| 1487944195 | Maria Renee Swim | Massage Therapist | 1675 Southdale Ctr, Edina, MN 55435-7015 | 2011-04-14 |
| 1972893774 | Kanchana Bunnithi | Massage Therapist | 1675 Southdale Ctr, Edina, MN 55435-7015 | 2011-04-13 |
| 1720378706 | Ocean Waves Massage & 02 Lounge | Massage Therapist | 1675 Southdale Ctr, Edina, MN 55435-7015 | 2011-04-12 |
| 1831489020 | Alethea Josephine Dawson | Massage Therapist | 1675 Southdale Ctr, Edina, MN 55435-7015 | 2011-04-09 |
| 1942590138 | Kelly Lynn Anderson | Massage Therapist | 1675 Southdale Ctr, Edina, MN 55435-7015 | 2011-04-09 |
| 1649560848 | Thitinuntha Ann Osmonson | Massage Therapist | 1675 Southdale Ctr, Edina, MN 55435-7015 | 2011-04-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104433416 | Evy Christine Claussen | Social Worker | 6363 France Ave. S., Edina, MN 55435 | 2020-09-30 |
| 1508496621 | Samantha Jean Mcgough Lamere | Physician Assistant | 4300 Marketpointe Drive, Suite 100, Bloomington, MN 55435 | 2020-01-16 |
| 1659920460 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 3408 Galleria, Edina, MN 55435 | 2019-09-05 |
| 1730651639 | Taylor Lee Kehoe | Physician Assistant | 7400 France Ave., Suite #100, Edina, MN 55435 | 2018-12-18 |
| 1538666326 | Amanda Deangelo | Physical Therapist | 6401 Southdale Hospital, Ll3g, Edina, MN 55435 | 2018-04-09 |
| 1982107876 | Julia Seliber | Dental Hygienist | 7600 France Ave.s. Suite 1100, Edina, MN 55435 | 2018-03-16 |
| 1154840064 | Southhealth Asc, LLC | Clinic/Center | 4100 Minnesota Drive, Edina, MN 55435 | 2017-09-12 |
| 1730605528 | Edina Medical Supplies | Durable Medical Equipment & Medical Supplies | 7455 France Ave., #614 S, Edina, MN 55435 | 2017-08-14 |
| 1033565510 | Minnesota Disc Replacement and Spine Restoration Center | Clinic/Center | 4444 76 St, #700, Edina, MN 55435 | 2016-05-13 |
| 1306206321 | Barb Ryan | Mechanotherapist | 7550 France Avenue S, #220, Edina, MN 55435 | 2016-03-03 |
| Find all providers in zip 55435 | ||||
| Taxonomy Code | 225700000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Massage Therapist |
| An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821388026 | Chollada Morpan Phan | Massage Therapist | 1675 Southdale Ctr, Edina, MN 55435-7015 | 2011-04-09 |
| 1992031835 | Tamara Rachelle Luck | Massage Therapist | 303 S East St, Edina, MO 63537-1543 | 2009-10-28 |
| 1245770510 | Lesley Simonson | Massage Therapist | 4570 W 77th St Ste 140, Edina, MN 55435-5004 | 2017-03-06 |
| 1205375433 | Equilibrium LLC | Massage Therapist | 4570 W 77th St, Suite 140, Edina, MN 55435-5008 | 2017-02-21 |
| 1639517022 | Milly Versalles | Massage Therapist | 7300 France Ave S, Suite 300, Edina, MN 55435-4525 | 2013-06-07 |
| 1174884712 | Levi Robert Hedine | Massage Therapist | 7300 France Ave S, Suite 300, Edina, MN 55435-4525 | 2012-05-30 |
| 1225398308 | Holly Louise Walker | Massage Therapist | 7300 France Ave S, Suite 300, Edina, MN 55435-4525 | 2012-05-22 |
| 1447526736 | Heidi Huebscher | Massage Therapist | 7400 Metro Blvd, Suite #360, Edina, MN 55439-2316 | 2012-03-30 |
| 1487944195 | Maria Renee Swim | Massage Therapist | 1675 Southdale Ctr, Edina, MN 55435-7015 | 2011-04-14 |
| 1972893774 | Kanchana Bunnithi | Massage Therapist | 1675 Southdale Ctr, Edina, MN 55435-7015 | 2011-04-13 |
| Find all providers in EDINA | ||||
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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.