CENTER FOR PRIMARY CARE AND REHABILITATION, PA (NPI# 1780963355) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780963355 |
| Entity Type | Organization |
| Organization Name | CENTER FOR PRIMARY CARE AND REHABILITATION, PA |
| Practice Address |
880 Blue Gentian Rd Ste 165 Eagan MN 55121-1772 |
| Mailing Address |
3006 Frank St Maplewood MN 55109-5501 |
| Practice Telephone | 6517898022 |
| Practice Fax Number | 6517898028 |
| Mailing Telephone | 6517898022 |
| Mailing Fax Number | 6517898028 |
| Enumeration Date | 2011-08-12 |
| Last Update Date | 2011-08-12 |
| Authorized Official Name | ELENA LEV POLUKHIN (OWNER/MEDICAL DIRECTOR) |
| Authorized Official Telephone | 6517898022 |
| Authorized Official Credential | MD, PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225400000X | Rehabilitation Practitioner | 45600 | MN | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
880 BLUE GENTIAN RD STE 165 |
| City | EAGAN |
| State | MN |
| Zip Code | 55121-1772 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205443850 | Birchwood Dental, LLC | Dentist | 3356 Sherman Crt Ste 101, Eagan, MN 55121 | 2020-09-28 |
| 1811552813 | Clare Muyskens | Physical Therapist | 3305 Central Park Commons Dr, Eagan, MN 55121 | 2019-05-06 |
| 1154986479 | Elp Right Living Health LLC | Assisted Living Facility | 3035 Eagandale Pl #101, Eagan, MN 55121 | 2019-05-02 |
| 1467908699 | Hy Vee Inc | Pharmacy | 1500 Central Park Commons Drive, Eagan, MN 55121 | 2016-08-28 |
| 1962861005 | Lakeline Transportation LLC | Non-emergency Medical Transport (VAN) | 1416 Shoreline Dr, Eagan, MN 55121 | 2016-02-17 |
| 1467838615 | John Berchem | Physical Therapist | 1284 Coporate Center Drive, #500, Eagan, MN 55121 | 2015-08-10 |
| 1730426099 | Carole P Cohen | Occupational Therapist | 880 Blue Gentian Road, Ste # 190, Eagan, MN 55121 | 2013-01-07 |
| 1407102882 | Emergency Physicians Professional Association | Clinic/Center | 3010 Denmark Avenue, Eagan, MN 55121 | 2012-08-03 |
| 1851692289 | Eagan Family Chiropractic & Massage | Chiropractor | 1260 Yankee Doodle Road, Suite 100, Eagan, MN 55121 | 2010-11-17 |
| 1780805218 | Bridget Marie Mcconnell | Social Worker | 680 O'neill Drive, Eagan, MN 55121 | 2007-05-01 |
| Find all providers in zip 55121 | ||||
| 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 |
|---|---|---|---|---|
| 1730538125 | Rachel Ohman | Rehabilitation Practitioner | 2030 Rahn Way, Eagan, MN 55122-2300 | 2016-06-07 |
| 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 |
| 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 |
| 1639131279 | Samuel Fedo | Rehabilitation Practitioner | 501 E Nicollet Blvd, Suite 100, Burnsville, MN 55337-6732 | 2006-04-06 |
| 1326653700 | Anika Evers | Rehabilitation Practitioner | 3640 9th St Nw, Rochester, MN 55901-6685 | 2020-09-11 |
| Find all providers with the same taxonomy | ||||
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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.