MRS. GRACE JEPCHIRCHIR FIDALGO (NPI# 1730722745) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730722745 |
| Entity Type | Individual |
| Full Name | MRS. GRACE JEPCHIRCHIR FIDALGO |
| Credential | RN |
| Practice Address |
6222 Hedgecroft Ave S Cottage Grove MN 55016-6002 |
| Practice Telephone | 6128598250 |
| Practice Fax Number | 6513305351 |
| Mailing Telephone | 6128598250 |
| Mailing Fax Number | 6513305351 |
| Enumeration Date | 2019-10-22 |
| Last Update Date | 2019-10-22 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 253J00000X | Foster Care Agency | 1099897 | MN | Agencies |
| Street Address |
6222 HEDGECROFT AVE S |
| City | COTTAGE GROVE |
| State | MN |
| Zip Code | 55016-6002 |
| 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 |
| 1255770962 | Southside At The Cottage Grove Site | Family Medicine | 8454 East Point Douglas Road, Cottage Grove, MN 55016 | 2013-06-17 |
| 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 |
| Find all providers in zip 55016 | ||||
| Taxonomy Code | 253J00000X |
| Grouping | Agencies |
| Classification | Foster Care Agency |
| A Foster Care Agency is an agency that provides foster care as defined in the Code of Federal Regulations (CFR) as "24-hour substitute care for children outside their own homes." Foster care settings include, but are not limited to, nonrelative foster family homes, relative foster homes (whether payments are being made or not), group homes, emergency shelters, residential facilities, and pre-adoptive homes. |
| Notes: Source: Code Of Federal Regulations, Title 45, Volume 4, Part 1355, Section 57 [1/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659979979 | South Star Care | Foster Care Agency | 3973 Willow Ridge Dr Sw, Rochester, MN 55902-2801 | 2020-10-09 |
| 1174138218 | Angelique Elizabeth Finifrock | Foster Care Agency | 10701 Becks Rd, Duluth, MN 55808 | 2020-09-15 |
| 1881211951 | Nordell Family Services LLC | Foster Care Agency | 4626 20th St Sw, Waverly, MN 55390-5004 | 2020-07-06 |
| 1285260497 | Yasmin Ahmed Sulayman | Foster Care Agency | 3433 Kenosha Dr Nw, Rochester, MN 55901-5707 | 2020-03-19 |
| 1023657285 | Julia Marie Bolte | Foster Care Agency | 3629 152nd Ln Nw, Andover, MN 55304-3008 | 2020-01-04 |
| 1467094102 | Lake Country Living Services LLC | Foster Care Agency | 181 Little Rock Rd Nw, Rice, MN 56367-8685 | 2019-10-15 |
| 1518508712 | Amanda Hesse | Foster Care Agency | 775 Lee Cir Se, Cokato, MN 55321-4697 | 2019-09-30 |
| 1275181661 | Alliance Homes Corporation | Foster Care Agency | 4946 Jackson St Ne, Columbia Heights, MN 55421-1709 | 2019-08-28 |
| 1760048078 | Kevin Carlyle Lunde X | Foster Care Agency | 1321 Merrywood Ct, Faribault, MN 55021-6529 | 2019-05-13 |
| 1043777667 | Kelly Ann Postudensek | Foster Care Agency | 3133 Chambersburg Ave, Duluth, MN 55811-3065 | 2019-03-01 |
| Find all providers with the same taxonomy | ||||
| City | COTTAGE GROVE |
| Zip Code | 55016 |
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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.