GEORGE THOMAS O'BRYAN (NPI# 1417061904) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1417061904 |
Entity Type | Individual |
Full Name | GEORGE THOMAS O'BRYAN |
Credential | M.D. |
Practice Address |
6363 France Ave S Suite 400 Edina MN 55435-2129 |
Practice Telephone | 9529202070 |
Practice Fax Number | 9529207444 |
Mailing Telephone | 9529202070 |
Mailing Fax Number | 9529207444 |
Enumeration Date | 2006-08-19 |
Last Update Date | 2007-12-03 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
36653 | MN | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MN | MEDICA PRIMARY | 3180156 | 01 |
MN | PHP | 3107053 | 01 |
MN | PREFERRED ONE | 1016006 | 01 |
WI | WISCONSIN MA | 32463400 | 01 |
MN | HEALTHPARTNERS | HP25085 | 01 |
MN | BCBS | 41Q33OB | 01 |
MN | 87401600 | 05 |
Street Address |
6363 FRANCE AVE S SUITE 400 |
City | EDINA |
State | MN |
Zip Code | 55435-2129 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1548235443 | Kristin Haugan | Family Medicine | 6363 France Ave S, Suite 525, Edina, MN 55435-2129 | 2006-02-22 |
1811515976 | Anna Quincer | Social Worker | 6363 France Ave S, Edina, MN 55435-2129 | 2020-07-06 |
1861971566 | Naysha Lavonne Stone | Counselor | 6363 France Ave S, Edina, MN 55435-2129 | 2018-08-13 |
1710409495 | Erica Lauren Miller Green | Nurse Practitioner | 6363 France Ave S, Edina, MN 55435-2129 | 2017-07-13 |
1235659830 | Michael Lemair | Social Worker | 6363 France Ave S, Edina, MN 55435-2129 | 2017-06-23 |
1821525668 | Rachel Bialostosky | Social Worker | 6363 France Ave S, Edina, MN 55435-2129 | 2017-05-11 |
1952849580 | Kristen Svendahl | Nurse Practitioner | 6363 France Ave S, Suite # 200, Edina, MN 55435-2129 | 2017-02-02 |
1982157590 | Jessica Anna Pivec | Clinical Exercise Physiologist | 6363 France Ave S, Suite 100, Edina, MN 55435-2129 | 2016-07-31 |
1720435563 | Ellen Wied | Counselor | 6363 France Ave S, Edina, MN 55435-1430 | 2016-05-23 |
1376912857 | Intermed Consultants Dialysis, Pllc | Internal Medicine | 6363 France Ave S, Suite 400, Edina, MN 55435-2129 | 2015-09-15 |
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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 |
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Taxonomy Code | 207RN0300X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Nephrology |
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1376912857 | Intermed Consultants Dialysis, Pllc | Internal Medicine | 6363 France Ave S, Suite 400, Edina, MN 55435-2129 | 2015-09-15 |
1942463229 | Oliver Tan Phan | Internal Medicine | 6363 France Ave S, Suite 400, Edina, MN 55435-2129 | 2008-07-07 |
1003922667 | David Lewis Bowlin | Internal Medicine | 6363 France Ave S, Suite 400, Edina, MN 55435-2129 | 2006-08-23 |
1194830463 | Jonathan Peter Tolins | Internal Medicine | 6363 France Ave S, Suite 400, Edina, MN 55435-2129 | 2006-08-20 |
1740394212 | James Hazelwood Somerville | Internal Medicine | 6363 France Ave S, Suite 400, Edina, MN 55435-2129 | 2006-08-19 |
1366556854 | Rajiv Ramanik Shah | Internal Medicine | 6363 France Ave S, Suite 400, Edina, MN 55435-2129 | 2006-08-19 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1649723420 | Stephanie Stackhouse | Internal Medicine | 5520 Bristol Lane, Minnetonka, MN 55343 | 2016-07-28 |
1841652146 | Deepthi Chandra Malepati | Internal Medicine | 717 Delaware Street Se, Mail Code 1932j, Minneapolis, MN 55414 | 2016-03-25 |
1538459755 | Maxwell David Leither | Internal Medicine | 6200 Shingle Creek Pkwy Ste 250, Brooklyn Center, MN 55430-2107 | 2011-04-08 |
1063650307 | Peter Paul Frohnert | Internal Medicine | 66 9th St E, Apt. 2305, Saint Paul, MN 55101-4700 | 2009-01-24 |
1164690475 | Paul Christian Seel | Internal Medicine | 2 Crocus Ln, Saint Paul, MN 55127-6302 | 2008-02-20 |
1619023918 | Vishal Sagar | Internal Medicine | 401 Phalen Blvd - Ms 41103c, Healthpartners Specialty Center 401, Saint Paul, MN 55130-5302 | 2007-01-27 |
1447343330 | Mark Alan Matson | Internal Medicine | 1000 Westgate Drive, Suite 149, St. Paul, MN 55114-5000 | 2006-10-02 |
1205945466 | Areef Ishani | Internal Medicine | 1 Veterans Dr # 111j, Minneapolis, MN 55417-2309 | 2006-08-30 |
1568489540 | Francis John Tycast | Internal Medicine | 19545 W Ford Brook Dr, Anoka, MN 55303-9580 | 2006-07-16 |
1255305355 | Brett W Nyholm | Internal Medicine | 6200 Shingle Creek Pkwy, Suite 250, Brooklyn Center, MN 55430-2128 | 2006-02-15 |
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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.