SOUTHSIDE AT THE COTTAGE GROVE SITE


Address: 8454 East Point Douglas Road, Cottage Grove, MN 55016
Phone: 6128212800

SOUTHSIDE AT THE COTTAGE GROVE SITE (NPI# 1255770962) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1255770962
Entity Type Organization
Organization Name SOUTHSIDE AT THE COTTAGE GROVE SITE
Practice Address 8454 East Point Douglas Road
Cottage Grove
MN 55016
Mailing Address 4243 4th Ave S
Minneapolis
MN 55409-2113
Practice Telephone 6128212800
Enumeration Date 2013-06-17
Last Update Date 2014-04-30
Authorized Official Name MR. WILLIAM HENRY TENDLE JR. (EXECUTIVE DIRECTOR)
Authorized Official Telephone 6128212800
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207Q00000X Family Medicine Allopathic & Osteopathic Physicians

Office Location

Street Address 8454 EAST POINT DOUGLAS ROAD
City COTTAGE GROVE
State MN
Zip Code 55016

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1073161519 Kathleen Johnson Technician 7436 Hinton Park Ave South, Cottage Grove, MN 55016 2019-08-28
1710473434 Cg Care Center, LLC. Skilled Nursing Facility 6993 80th Street South, Cottage Grove, MN 55016 2018-07-05
1235532771 Lydia Sirucek Nurse Practitioner 8611 E Point Douglas Rd, Cottage Grove, MN 55016 2014-09-29
1366859746 Home Care Service Providers Inc. Home Health 9635 Hamlet Ave, Cottage Grove, MN 55016 2014-07-17
1942622089 Wal-mart Stores, Inc. Technician/Technologist 9300 East Point Douglas Rd S, Cottage Grove, MN 55016 2014-01-08
1710222088 Santori Chiropractic Center, LLC Chiropractor 7155 80th Street So, Cottage Grove, MN 55016 2012-11-28
1609151414 Kenneth Nworah Okafor Pharmacist 7015 East Point Douglas Road, Cottage Grove, MN 55016 2011-10-13
1134432925 Elizabeth Frances Rezek Social Worker 8813 Hale Ave S, Cottage Grove, MN 55016 2010-07-21
1841420882 Mark Joseph Mangine Physical Therapist 6936 Pine Arbor Dr S Ste 150, Cottage Grove, MN 55016 2009-07-24
1770713018 Ramona L Westerberg Massage Therapist 7850 Lamar Ave S, Cottage Grove, MN 55016 2009-07-21
Find all providers in zip 55016

Taxonomy Information

Taxonomy Code 207Q00000X
Grouping Allopathic & Osteopathic Physicians
Classification Family Medicine

Taxonomy Definition

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.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1821363227 James Michael Tandrow Family Medicine 205 Buttercup Loop, Cottage Grove, OR 97424-2069 2012-03-19
1922322619 Sheryl Spitzer -resnick Md, LLC Family Medicine 251 East Cottage Grove Road, Cottage Grove, WI 53527 2010-03-24
1821277716 Shaswita Chintalpuri Family Medicine 7500 80th Street South, Suite 100 - Mail Stop 34624a, Healthpartners Cottage Grove Clinic, Cottage Grove, MN 55016-3008 2007-10-29
1912120114 Mary E Gabriele Family Medicine 502 E Whiteaker Ave, Cottage Grove, OR 97424-1648 2007-04-10
1386769735 Joseph R.f. Kalugdan Family Medicine 7500 80th St S Ste 100, Healthpartners Cottage Grove Clinic, Cottage Grove, MN 55016-3008 2007-03-21
1275663247 Paul A Bilder Family Medicine 1445 Gateway Blvd., Cottage Grove, OR 97424 2007-03-07
1225115124 Wildwood Family Clinic, Sc Family Medicine 535 Southing Grange, Cottage Grove, WI 53527-9338 2006-11-01
1487748943 Katrina Carol Groves-rehwaldt Family Medicine 1515 Village Dr Ste 200, Cottage Grove, OR 97424 2006-10-02
1215980792 Martha J Masciopinto Family Medicine 10010 Kimbro Ave S, Cottage Grove, MN 55016-4151 2006-05-18
1821059692 Stacey L Ko Family Medicine 7500 80th St S, Suite 100 - Ms 34624a, Healthpartners Cottage Grove Clinic, Cottage Grove, MN 55016-3008 2006-03-31
Find all providers in COTTAGE GROVE

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City COTTAGE GROVE
Zip Code 55016

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Dataset Information

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.

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