DR. JESSICA CHIYOKO FEDOR (NPI# 1801980537) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801980537 |
| Entity Type | Individual |
| Full Name | DR. JESSICA CHIYOKO FEDOR |
| Credential | O.D. |
| Practice Address |
9055 Springbrook Dr Nw Coon Rapids MN 55433 |
| Mailing Address |
2925 Chicago Ave Minneapolis MN 55407-1321 |
| Practice Telephone | 7637809155 |
| Practice Fax Number | 7632361066 |
| Mailing Telephone | 6122625000 |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2019-08-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 3028 | MN | Eye and Vision Services Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 680 Highway 10 Ne, Blaine, MN 55434 | 7637852200 | |
| 7545 Veterans Dr, Ramsey, MN 553037500 | 6124671100 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548500606 | Jessica Lynn Fedor | Physician Assistant | 8740 N Kendall Dr Ste 115, Miami, FL 33176 | 2013-02-26 |
| Street Address |
9055 SPRINGBROOK DR NW |
| City | COON RAPIDS |
| State | MN |
| Zip Code | 55433 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306833454 | Julie M Jones | Internal Medicine | 9055 Springbrook Dr Nw, Coon Rapids, MN 55433-5841 | 2005-10-04 |
| 1235745126 | Allison Usset Gilles | Nurse Practitioner | 9055 Springbrook Dr Nw, Coon Rapids, MN 55433-5841 | 2020-09-16 |
| 1649886565 | Allina Health System | Clinic/Center | 9055 Springbrook Dr Nw, Coon Rapids, MN 55433-5841 | 2020-09-16 |
| 1851924302 | Jenna Michele Borgstrom | Physician Assistant | 9055 Springbrook Dr Nw, Coon Rapids, MN 55433-5841 | 2020-02-12 |
| 1346887585 | Andria Sammon | Nurse Practitioner | 9055 Springbrook Dr Nw, Coon Rapids, MN 55433-5841 | 2019-12-06 |
| 1679126080 | Kayla Wenner | Dietitian, Registered | 9055 Springbrook Dr Nw, Coon Rapids, MN 55433 | 2019-07-24 |
| 1710541586 | Meri Ellen Parady | Social Worker | 9055 Springbrook Dr Nw, Coon Rapids, MN 55433-5841 | 2019-04-27 |
| 1659835734 | Alisha Leigh Freeburg | Registered Nurse | 9055 Springbrook Dr Nw, Coon Rapids, MN 55433-5841 | 2019-01-23 |
| 1588146732 | Erika Janet Hachey | Nurse Practitioner | 9055 Springbrook Dr Nw, Coon Rapids, MN 55433-5841 | 2018-09-04 |
| 1083192702 | Hannah Mork | Audiologist | 9055 Springbrook Dr Nw, Coon Rapids, MN 55433-5841 | 2018-08-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770134793 | Shelley Karee Peterson | Technician | 10311 Bittersweet St Nw, Coon Rapids, MN 55433 | 2019-09-20 |
| 1578122057 | Courtney Gau | Behavior Technician | Fraser Coon Rapids, 9120 Springbrook Dr. Nw, Coon Rapids, MN 55433 | 2019-06-10 |
| 1992275606 | Maliki Fofee Kamara | Licensed Practical Nurse | 2451 109th Ave Nw Apt. 1, Coon Rapids, MN 55433 | 2018-11-26 |
| 1992284541 | Sarah Vennes | Massage Therapist | 6400 Flying Cloud Dr, Suite 240, Eden Prairie, MN 55433 | 2018-08-13 |
| 1538646609 | Paige Prince | Behavior Technician | Fraser Coon Rapids, 9120 Springbrook Drive Nw, Coon Rapids, MN 55433 | 2018-07-23 |
| 1154828242 | Karin Lea Englund | Dentist | 9145 Springbrook Dr Nw Ste 100, Coon Rapids, MN 55433 | 2018-04-06 |
| 1235642513 | Vista Family Eye Care LLC | Optometrist | 9920 Foley Blvd Nw Ste 120, Coon Rapids, MN 55433 | 2017-11-09 |
| 1538697818 | Mohammed Nmn Ahmed | Internal Medicine | 9055 Spring Brook Drive, Allina Coon Rapids Clinic 9055, Coon Rapids, MN 55433 | 2017-05-31 |
| 1639531353 | Journi LLC | Nurse Practitioner | 277 Coon Rapids Blvd Suite 308, Coon Rapids, MN 55433 | 2016-03-22 |
| 1821457722 | Honorine Boyce | Licensed Practical Nurse | 2743 111th Ave. Nw, Coon Rapids, MN 55433 | 2016-02-19 |
| Find all providers in zip 55433 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235642513 | Vista Family Eye Care LLC | Optometrist | 9920 Foley Blvd Nw Ste 120, Coon Rapids, MN 55433 | 2017-11-09 |
| 1588790729 | Chad David Kalil | Optometrist | 3777 Coon Rapids Boulevard, Suite 100, Coon Rapids, MN 55433 | 2007-02-24 |
| 1871629170 | Timothy Steven Johnson | Optometrist | 12771 Riverdale Blvd Nw Ste 103, Coon Rapids, MN 55448-1263 | 2007-02-23 |
| 1710079892 | Kara Durick Johnson | Optometrist | 12771 Riverdale Blvd Nw, Suite 103, Coon Rapids, MN 55448-1262 | 2006-09-28 |
| 1922038926 | Timothy Eggimann | Optometrist | 3777 Coon Rapids Blvd Nw Ste 100, Coon Rapids, MN 55433-2630 | 2006-07-04 |
| 1164424370 | Robert Dodge | Optometrist | 12737 Riverdale Blvd Nw, Coon Rapids, MN 55448-1253 | 2005-06-01 |
| 1760968895 | Margaret Mary Shipitalo | Optometrist | 3777 Coon Rapids Blvd Nw Ste 100, Coon Rapids, MN 55433-2630 | 2018-07-11 |
| 1568873123 | Becky Yeung | Optometrist | 3777 Coon Rapids Blvd Nw, Suite 100, Coon Rapids, MN 55433-2630 | 2014-05-16 |
| 1609292077 | Jd Eyes, Inc | Optometrist | 12771 Riverdale Blvd Nw, Suite 103, Coon Rapids, MN 55448-1262 | 2014-03-10 |
| 1285918268 | Paul Chadima Hammond | Optometrist | 3777 Coon Rapids Blvd Nw, Suite 100, Coon Rapids, MN 55433-2630 | 2011-10-07 |
| Find all providers in COON RAPIDS | ||||
| City | COON RAPIDS |
| Zip Code | 55433 |
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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.