SAMUEL FEDO (NPI# 1639131279) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639131279 |
| Entity Type | Individual |
| Full Name | SAMUEL FEDO |
| Credential | ATC |
| Practice Address |
501 E Nicollet Blvd Suite 100 Burnsville MN 55337-6732 |
| Practice Telephone | 9524604900 |
| Practice Fax Number | 9524604901 |
| Mailing Telephone | 9524604900 |
| Mailing Fax Number | 9524604901 |
| Enumeration Date | 2006-04-06 |
| Last Update Date | 2011-02-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225400000X | Rehabilitation Practitioner | 1739 | MN | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
501 E NICOLLET BLVD SUITE 100 |
| City | BURNSVILLE |
| State | MN |
| Zip Code | 55337-6732 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174945513 | Patricia Daly Borg | Registered Nurse | 501 E Nicollet Blvd, Ste. 120, Burnsville, MN 55337-6732 | 2014-01-18 |
| 1508050543 | Fairview Clinics | Clinic/Center | 501 E Nicollet Blvd, Ste 120, Burnsville, MN 55337-6732 | 2007-09-04 |
| 1891902193 | Eric Raymond Marvin | Orthotist | 501 E Nicollet Blvd, Ll50, Burnsville, MN 55337-6732 | 2007-05-17 |
| 1659417210 | Shonalie Leville | Pediatrics | 501 E Nicollet Blvd, Ste 200, Burnsville, MN 55337-6732 | 2007-01-30 |
| 1689772709 | Saira Mitha | Pediatrics | 501 E Nicollet Blvd, Ste 200, Burnsville, MN 55337-6732 | 2006-09-20 |
| 1649378746 | Barbara J Hansen | Pediatrics | 501 E Nicollet Blvd, Ste 200, Burnsville, MN 55337-6732 | 2006-09-20 |
| 1639277742 | Debra L Magnuson | Pediatrics | 501 E Nicollet Blvd, Ste 200, Burnsville, MN 55337-6732 | 2006-09-20 |
| 1356449474 | Amy L Manolis | Pediatrics | 501 E Nicollet Blvd, Ste 200, Burnsville, MN 55337-6732 | 2006-09-20 |
| 1285742916 | Jeffrey Ryan Mathews | Physical Therapist | 501 E Nicollet Blvd, #100, Burnsville, MN 55337-6732 | 2006-08-25 |
| 1144335605 | Lisa Wilkinson Oie | Pediatrics | 501 E Nicollet Blvd, Ste 200, Burnsville, MN 55337-6732 | 2006-08-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053939397 | Alpha Quality Care1 L. L. C. | Home Infusion | 12924 18th Ave South, Burnsville, MN 55337 | 2020-07-13 |
| 1568085900 | Kathryn Harris | Counselor | 11939 W. River Hills Dr., Burnsville, MN 55337 | 2020-05-20 |
| 1952941254 | Noah Home Care Inc. | Home Health | 13521 Nicollet Lane, Burnsville, MN 55337 | 2020-01-14 |
| 1750854287 | Baraka Home Care LLC | Nursing Care | 1700 James Place, Burnsville, MN 55337 | 2019-01-08 |
| 1699298778 | Raphael Cheron-dittmann | Hearing Instrument Specialist | 14000 Nicollet Ave. S., Suite 303, Burnsville, MN 55337 | 2017-07-20 |
| 1669909818 | Mercy Home Care Ltd | Hospice Care, Community Based | 1020 E 146th St Ste 220d, Burnsville, MN 55337 | 2017-05-18 |
| 1457893984 | Daniel Ryan Nguyen | Physician Assistant | 14551 Co Rd #11 #100, Burnsville, MN 55337 | 2016-11-15 |
| 1730542572 | Iris Reproductive Psychiatric Clinic | Clinical Nurse Specialist | 1500 Mcandrews Road W, Ste 227, Burnsville, MN 55337 | 2016-03-30 |
| 1740657204 | Mercy Link, LLC | Home Health | 13005 Salem Pl, Burnsville, MN 55337 | 2015-08-31 |
| 1669852158 | Mixa Dipak Patel | Physical Therapy Assistant | 8380 Hiawatha Ave, Eden Prairie, MN 55337 | 2015-06-01 |
| Find all providers in zip 55337 | ||||
| Taxonomy Code | 225400000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Rehabilitation Practitioner |
| A health care practitioner who trains or retrains individuals disabled by disease or injury to help them attain their maximum functional capacity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700306826 | Shaley Zweber | Rehabilitation Practitioner | 201 E Nicollet Blvd, Burnsville, MN 55337-5714 | 2017-06-20 |
| 1942424775 | Pauline M Malecha | Rehabilitation Practitioner | 201 E Nicollet Blvd, Burnsville, MN 55337-5714 | 2007-04-12 |
| 1851473482 | Margaret Anne Kratz | Rehabilitation Practitioner | 201 E Nicollet Blvd, Burnsville, MN 55337-5714 | 2006-10-20 |
| 1033291646 | Teresa Lynn Fietek | Rehabilitation Practitioner | 201 E Nicollet Blvd, Burnsville, MN 55337-5714 | 2006-10-20 |
| 1477635001 | Dana Loo | Rehabilitation Practitioner | 201 E Nicollet Blvd, Burnsville, MN 55337-5714 | 2006-10-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629615612 | Livelife Therapy Solutions | Rehabilitation Practitioner | 8100 Penn Ave S Ste 137, Bloomington, MN 55431-1325 | 2019-12-09 |
| 1962067611 | Connor Hanson | Rehabilitation Practitioner | 718 1st Ave Nw, New Brighton, MN 55112-6809 | 2019-05-08 |
| 1780963355 | Center for Primary Care and Rehabilitation, Pa | Rehabilitation Practitioner | 880 Blue Gentian Rd Ste 165, Eagan, MN 55121-1772 | 2011-08-12 |
| 1518192756 | David Michael Noren | Rehabilitation Practitioner | 521 Broadway Ave N, Braham, MN 55006 | 2009-05-18 |
| 1972764454 | Laura Lynn Kirlin | Rehabilitation Practitioner | 515 Bridge St. East, Park Rapids, MN 56470-1810 | 2008-06-18 |
| 1801084140 | Anthony Kroll | Rehabilitation Practitioner | 3609 White Bear Ave N, Suite #202, White Bear Lake, MN 55110-4466 | 2007-10-11 |
| 1609906734 | Paul Daniel Nistler | Rehabilitation Practitioner | 722 15th Street Ne, Bemidji, MN 56601 | 2007-03-07 |
| 1881747483 | Richard Marquardt | Rehabilitation Practitioner | Upper Mississippi Mental Health Center, 120 N Main Street, Park Rapids, MN 56470 | 2007-01-19 |
| 1346327004 | Shawn D. Anderson | Rehabilitation Practitioner | 515 Bridge St, Park Rapids, MN 56470-1210 | 2006-11-01 |
| 1326653700 | Anika Evers | Rehabilitation Practitioner | 3640 9th St Nw, Rochester, MN 55901-6685 | 2020-09-11 |
| Find all providers with the same taxonomy | ||||
| City | BURNSVILLE |
| Zip Code | 55337 |
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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.