KATHERINE MOODY (NPI# 1194809400) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194809400 |
| Entity Type | Individual |
| Full Name | KATHERINE MOODY |
| Credential | P.A. |
| Practice Address |
6405 France Ave S Suite W200 Edina MN 55435-2163 |
| Practice Telephone | 9529249005 |
| Practice Fax Number | 9529152443 |
| Mailing Telephone | 9529249005 |
| Mailing Fax Number | 9529152443 |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2009-08-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 10589 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
085-002505 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831658038 | Katherine Moody | Student in an Organized Health Care Education/Training Program | 1542 Tulane Ave Rm 436, New Orleans, LA 70112-2865 | 2019-03-18 |
| 1215540117 | Katherine J Moody | Occupational Therapist | 110 Fairfax Rd, Saint Albans, VT 05478-6299 | 2020-08-28 |
| 1124671193 | Katherine C Moody | Behavioral Analyst | 32100 Telegraph Rd Ste 205, Bingham Farms, MI 48025-2454 | 2019-07-18 |
| 1043794282 | Katherine Elizabeth Nelson Moody | Counselor | 10427 Detroit Ave, Cleveland, OH 44102-1645 | 2018-09-24 |
| 1134482474 | Katherine Russell Moody | Family Medicine | 301 Governors Dr Sw, Huntsville, AL 35801 | 2012-06-21 |
| Street Address |
6405 FRANCE AVE S SUITE W200 |
| City | EDINA |
| State | MN |
| Zip Code | 55435-2163 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710972864 | Demosthenes N Iskos | Internal Medicine | 6405 France Ave S, Suite W200, Edina, MN 55435-2163 | 2005-09-14 |
| 1790145738 | Aybike Bakan-fischer | Physician Assistant | 6405 France Ave S, Edina, MN 55435-2163 | 2016-03-03 |
| 1225496128 | Stephanie Rose Norgaard-erickson | Nurse Practitioner | 6405 France Ave S, Suite W200, Edina, MN 55435-2163 | 2016-02-05 |
| 1851717136 | Eric Richard Nelson Md | Ophthalmology | 6405 France Ave S, Suite W460, Edina, MN 55435-2163 | 2014-03-11 |
| 1538599790 | Fairview Health Services | Clinic/Center | 6405 France Ave S, Suite 480, Edina, MN 55435 | 2013-11-25 |
| 1538504014 | Erin Jean Frendin | Physician Assistant | 6405 France Ave S, Ste W200, Edina, MN 55435-2163 | 2013-05-09 |
| 1689937963 | Brittany N Smith | Physician Assistant | 6405 France Ave S, Edina, MN 55435 | 2012-06-21 |
| 1336409978 | Katherine Eileen Hawkins | Surgery | 6405 France Ave S, Edina, MN 55435-2163 | 2012-05-16 |
| 1265721906 | Joy A Hasseler | Obstetrics & Gynecology | 6405 France Ave S, Ste W400, Edina, MN 55435-2163 | 2011-04-04 |
| 1710133343 | Fairview Express Care | Internal Medicine | 6405 France Ave S, Ste 200, Edina, MN 55435-2163 | 2008-08-14 |
| Find all providers in the same location | ||||
| 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 | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033756168 | Chandler R Hutton | Physician Assistant | 6550 York Ave S Ste 112, Edina, MN 55435-2332 | 2019-12-09 |
| 1619529369 | Mh 101, PC | Physician Assistant | 6801 Washington Ave S Ste 100, Edina, MN 55439-1523 | 2019-07-12 |
| 1730651639 | Taylor Lee Kehoe | Physician Assistant | 7400 France Ave., Suite #100, Edina, MN 55435 | 2018-12-18 |
| 1346676319 | Catherine Anne Cecconi | Physician Assistant | 6545 France Ave S Ste 586, Edina, MN 55435 | 2013-09-22 |
| 1255619813 | Evan M Burgart | Physician Assistant | 6363 France Ave S Ste 400, Edina, MN 55435-2130 | 2011-08-01 |
| 1962737981 | Melissa Faye Hall | Physician Assistant | 6363 France Avenue South, Suite 400, Edina, MN 55435 | 2009-10-08 |
| 1588825145 | Bennett Ezra Goltz | Physician Assistant | 6363 France Ave S Ste 103, Edina, MN 55435 | 2008-06-17 |
| 1013105907 | Maisy Monica Sanneman | Physician Assistant | 6525 France Ave. S., Suite 200, Edina, MN 55435 | 2007-10-05 |
| 1699701672 | Sarah Teresa Bot | Physician Assistant | 6525 France Ave South, Suite 100, Edina, MN 55435-3624 | 2006-06-23 |
| 1336108224 | J Robert Noel IIi | Physician Assistant | Fairview Geriatric Services, 7505 Metro Blvd Suite 100, Edina, MN 55439 | 2006-03-21 |
| 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.