FAMILY HEALTHSERVICES MINNESOTA, P.A. (NPI# 1639359359) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1639359359 |
Entity Type | Organization |
Organization Name | FAMILY HEALTHSERVICES MINNESOTA, P.A. |
Other Organization Name | ENTIRA FAMILY CLINICS-WHITE BEAR LAKE-BANNING AVENUE |
Practice Address |
4786 Banning Ave White Bear Lake MN 55110-3264 |
Mailing Address |
2025 Sloan Pl Suite 35 Saint Paul MN 55117-2007 |
Practice Telephone | 6514266402 |
Practice Fax Number | 6514293402 |
Mailing Telephone | 6517721572 |
Mailing Fax Number | 6517721889 |
Enumeration Date | 2007-11-09 |
Last Update Date | 2012-05-21 |
Authorized Official Name | PAUL BERRISFORD (COO) |
Authorized Official Telephone | 6517721572 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207Q00000X | Family Medicine | 1428 | MN | Allopathic & Osteopathic Physicians |
Other Name | Type Code |
---|---|
Entira Family Clinics-White Bear Lake-Banning Avenue | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1124206677 | Family Healthservices Minnesota, P.a. | Family Medicine | 2025 Sloan Pl, Suite 35, Saint Paul, MN 55117-2007 | 2008-02-07 |
1427190537 | Family Healthservices Minnesota, P.a. | Non-Pharmacy Dispensing Site | 1814 N Saint Paul Rd, Maplewood, MN 55109-4700 | 2007-02-13 |
1588807895 | Family Healthservices Minnesota, P.a. | Non-Pharmacy Dispensing Site | 234 Wentworth Ave E, West St Paul, MN 55118-3525 | 2009-04-16 |
1528248259 | Family Healthservices Minnesota, P.a. | Family Medicine | 3550 Labore Rd, Suite 7, Saint Paul, MN 55110-7505 | 2007-11-09 |
1437339165 | Family Healthservices Minnesota, P.a. | Family Medicine | 3220 Bellaire Ave, White Bear Lake, MN 55110-5854 | 2007-11-09 |
1538349253 | Family Healthservices Minnesota, P.a. | Family Medicine | 2980 Buckley Way, Inver Grove Heights, MN 55076-2017 | 2007-11-09 |
1790965424 | Family Healthservices Minnesota, P.a. | Family Medicine | 2056 Woodlane Dr, Woodbury, MN 55125-2917 | 2007-11-09 |
1629258348 | Family Healthservices Minnesota, P.a. | Family Medicine | 1540 Randolph Ave, Saint Paul, MN 55105-2535 | 2007-11-09 |
1538349261 | Family Healthservices Minnesota, P.a. | Family Medicine | 1814 N Saint Paul Rd, Maplewood, MN 55109-4700 | 2007-11-09 |
1801076526 | Family Healthservices Minnesota, P.a. | Family Medicine | 234 Wentworth Ave E, West St Paul, MN 55118-3525 | 2007-11-09 |
Street Address |
4786 BANNING AVE |
City | WHITE BEAR LAKE |
State | MN |
Zip Code | 55110-3264 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1831141886 | Ann M Barry | Family Medicine | 4786 Banning Ave, White Bear Lake, MN 55110 | 2006-05-17 |
1346713476 | Maria Elizabeth Cook | Physician Assistant | 4786 Banning Ave, White Bear Lake, MN 55110-3264 | 2019-01-11 |
1982077061 | Nicole Altstatt | Nurse Practitioner | 4786 Banning Ave, White Bear Lake, MN 55110-3264 | 2015-11-11 |
1730520008 | Nicole Marie Harvey | Physician Assistant | 4786 Banning Ave, White Bear Lake, MN 55110-3264 | 2013-07-15 |
1366751562 | Minnesota Institute for Pain Management, LLC | Physical Medicine & Rehabilitation | 4786 Banning Ave, White Bear Lake, MN 55110-3264 | 2010-10-05 |
1356668123 | Stacy Marie Smith | Physician Assistant | 4786 Banning Ave, White Bear Lake, MN 55110-3264 | 2010-05-03 |
1871710988 | Minnhealth Family Physicians, P.a. | Family Medicine | 4786 Banning Ave, White Bear Lake, MN 55110-3264 | 2007-04-19 |
1720120645 | Family Healthservices Minnesota, P.a | Non-Pharmacy Dispensing Site | 4786 Banning Ave, White Bear Lake, MN 55110-3264 | 2007-02-14 |
1972510634 | David C Thorson | Family Medicine | 4786 Banning Ave, White Bear Lake, MN 55110-3264 | 2006-08-02 |
1063428746 | Carol K Stark | Family Medicine | 4786 Banning Ave, White Bear Lake, MN 55110-3264 | 2006-08-01 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1467071084 | St. Catherine University School Based Health Clinic | Nurse Practitioner | 5045 Division Ave, White Bear Lake, MN 55110 | 2020-04-14 |
1922450618 | Lisa Marie Thatcher | Podiatrist | 4653 White Bear Pkwy., St. Paul, MN 55110 | 2016-07-06 |
1558725598 | White Bear Dentists, PC | Dentist | 1970 Buerkle Road, White Bear Lake, MN 55110 | 2016-04-06 |
1124486246 | Julie Blaske | Counselor | 1310 Hwy 96 E, Suite 200, White Bear Lake, MN 55110 | 2016-02-03 |
1851761514 | Supervalu Pharmacies Inc | Durable Medical Equipment & Medical Supplies | 1920 Buerkle Rd, White Bear Lake, MN 55110 | 2015-10-06 |
1821496969 | Leah Eichmiller | Acupuncturist | 2183 3rd Street, C/o Indulge Salon, White Bear Lake, MN 55110 | 2014-12-05 |
1447672084 | Ashley Rath | Chiropractor | 1247 Gun Club Rd., White Bear Lake, MN 55110 | 2014-01-16 |
1790121291 | Advanced Medical Home Care, LLC | Home Health | 2555 County Road E East, Suite 101, White Bear Lake, MN 55110 | 2013-05-11 |
1134468465 | Emergency Physicians Professional Association | Clinic/Center | 1159 E. County Road E, Vadnais Heights, MN 55110 | 2013-02-06 |
1639444284 | Rebecca Lynn Blaede | Counselor | 4858 Banning Avenue, White Bear Lake, MN 55110 | 2012-03-15 |
Find all providers in zip 55110 |
Taxonomy Code | 207Q00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Family Medicine |
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. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1295349280 | Anna Dalrymple | Family Medicine | 3832 Mcknight Rd N, White Bear Lake, MN 55110-4874 | 2020-09-07 |
1477797264 | Patrick Thomas Dornack | Family Medicine | 2555 County Road E E, White Bear Lake, MN 55110-4906 | 2009-04-24 |
1700897881 | John P Hamerly | Family Medicine | 3220 Bellaire Ave, White Bear Lake, MN 55110-5854 | 2006-08-11 |
1831141886 | Ann M Barry | Family Medicine | 4786 Banning Ave, White Bear Lake, MN 55110 | 2006-05-17 |
1720030083 | Teresa A Pena | Family Medicine | 4525 White Bear Pkwy, Suite 130, White Bear Lake, MN 55110-7651 | 2006-05-16 |
1992772354 | Danielle R Perry | Family Medicine | 4422 White Bear Ave, White Bear Lake, MN 55110 | 2006-03-03 |
1245205301 | Jennifer A Lake | Family Medicine | 4422 White Bear Ave N, White Bear Lake, MN 55110-3475 | 2006-02-22 |
1437150877 | Aalfa Family Practice Pa | Family Medicine | 4465 White Bear Pkwy, White Bear Lake, MN 55110-7626 | 2005-08-09 |
1699126169 | Tou Lee Xiong | Family Medicine | 1430 Highway 96 E, White Bear Lake, MN 55110-3653 | 2016-06-27 |
1669882791 | Jenna Keller | Family Medicine | 1430 Highway 96 E, White Bear Lake, MN 55110-3653 | 2014-04-28 |
Find all providers in WHITE BEAR LAKE |
City | WHITE BEAR LAKE |
Zip Code | 55110 |
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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.