TARGET CLINIC (NPI# 1447648506) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447648506 |
| Entity Type | Organization |
| Organization Name | TARGET CLINIC |
| Practice Address |
1300 University Ave W Saint Paul MN 55104-4103 |
| Practice Telephone | 6516421146 |
| Mailing Telephone | 6516421146 |
| Enumeration Date | 2014-12-24 |
| Last Update Date | 2014-12-24 |
| Authorized Official Name | CHRISTY BERRYHILL (FNP) |
| Authorized Official Telephone | 6123275134 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | R 158470 3 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023448644 | Target Clinic | Clinic/Center | 1154 S Clark St, Chicago, IL 60605-2159 | 2013-11-18 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | Target Clinic Medical Associates Virginia LLC | 1000 Nicollet Mall, Tps 1797, Minneapolis, Minnesota 55403 |
| Street Address |
1300 UNIVERSITY AVE W |
| City | SAINT PAUL |
| State | MN |
| Zip Code | 55104-4103 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962424648 | Grand St Paul Cvs LLC | Pharmacy | 1300 University Ave W, Saint Paul, MN 55104-4103 | 2006-07-24 |
| 1649786138 | Ikechukwu Okechukwu | Nurse Practitioner | 1300 University Ave W, Saint Paul, MN 55104-4103 | 2017-12-19 |
| 1356719918 | Jeena Lee | Pharmacist | 1300 University Ave W, Saint Paul, MN 55104-4103 | 2015-09-11 |
| 1861881625 | Stephanie Marie Weinberger | Psychiatry & Neurology | 1300 University Ave W, Saint Paul, MN 55104-4103 | 2015-01-16 |
| 1124436464 | David Andrew Spande | Optometrist | 1300 University Ave W, Optical Clinic, Saint Paul, MN 55104-4103 | 2014-07-31 |
| 1245659903 | Tara Marie Olson | Nurse Practitioner | 1300 University Ave W, Saint Paul, MN 55104-4103 | 2014-04-09 |
| 1497027825 | Nicholas Maddux | Pharmacist | 1300 University Ave W, Saint Paul, MN 55104-4103 | 2012-02-01 |
| 1760779649 | Trenton William Srstka | Pharmacist | 1300 University Ave W, Saint Paul, MN 55104-4103 | 2011-06-29 |
| 1336434794 | Tara Jean Tindall | Pharmacist | 1300 University Ave W, Saint Paul, MN 55104-4103 | 2011-06-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891339131 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 1600 University Ave West, Suite 12, Room P, Saint Paul, MN 55104 | 2019-10-30 |
| 1629541644 | Michael P Cain | Counselor | 1821 University Ave West, Suite N385, St. Paul, MN 55104 | 2019-01-03 |
| 1295219657 | Awaken Recovery Center L.l.c | Counselor | 400 Suite D 393 North Dunlap, St Paul, MN 55104 | 2018-09-21 |
| 1285115634 | American Current Care of Minnesota PC | Clinic/Center | 570 Asbury St Ste 101, Saint Paul, MN 55104 | 2018-08-23 |
| 1699262501 | B & M Vital Homecare LLC. | Home Health | 1821 University Ave., W., Ste #s334, St. Paul, MN 55104 | 2018-04-16 |
| 1134621600 | Lauren Fullerton | Counselor | 1821 University Ave W., Suite N385, St. Paul, MN 55104 | 2018-03-01 |
| 1265944672 | Megan Manning | Marriage & Family Therapist | 475 Cleveland Ave. N., Suite 316, St. Paul, MN 55104 | 2017-10-26 |
| 1801305131 | Foncham Buma Foncham | Registered Nurse | 856 University Avenue, W, St. Paul, MN 55104 | 2017-09-29 |
| 1750802476 | Ha Vo | Counselor | 451 Lexington Parkway North, St. Paul, MN 55104 | 2017-07-03 |
| 1952831026 | Noble Senior Center Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1094 University Ave W, Saint Paul, MN 55104 | 2017-06-12 |
| Find all providers in zip 55104 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063039378 | Samantha Dion Richardson | Nurse Practitioner | 3225 Dogwood Dr, Saint Paul, VA 24283-2543 | 2020-07-02 |
| 1033547708 | Jane Monita | Nurse Practitioner | 225 Smith Ave N Ste 200, Saint Paul, MN 55102-2697 | 2013-10-16 |
| 1851541239 | Emily A. Wolfe | Nurse Practitioner | 640 Jackson St - Mc 11108b, Healthpartners Regions Specialty Clinics, Saint Paul, MN 55101-2502 | 2008-09-23 |
| 1629264668 | Chris-ann Lauria | Nurse Practitioner | 1145 Homer St, Saint Paul, MN 55116-3231 | 2007-09-24 |
| 1871790956 | Susan M Knier | Nurse Practitioner | 178 9th St E, Saint Paul, MN 55101 | 2007-07-02 |
| 1275625485 | Michele Johnson | Nurse Practitioner | 916 Rice St, Saint Paul, MN 55117-5425 | 2006-09-28 |
| 1063517100 | Samuel Yaw Boadu | Nurse Practitioner | 409 North Dunlap Street, Open Cities Health Center, Saint Paul, MN 55104-4201 | 2006-09-13 |
| 1205843307 | Jean Marie Kummer Iv | Nurse Practitioner | 4831 Richard Ln, Saint Paul, MN 55122-2784 | 2006-08-02 |
| 1568489037 | Anna Mergit Novak | Nurse Practitioner | 1055 Westgate Dr Ste 100, Saint Paul, MN 55114-1451 | 2006-07-17 |
| 1144287251 | Diane M Budnick | Nurse Practitioner | 1700 University Ave W, Medical Advanced Pain Specialists, Saint Paul, MN 55104-3727 | 2006-05-01 |
| Find all providers in SAINT PAUL | ||||
| City | SAINT PAUL |
| Zip Code | 55104 |
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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.