ACTIVE FEET, FOOT & ANKLE HEALTH CENTER (NPI# 1861825093) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861825093 |
| Entity Type | Organization |
| Organization Name | ACTIVE FEET, FOOT & ANKLE HEALTH CENTER |
| Other Organization Name | MIDWEST PODIATRY CENTERS |
| Practice Address |
10995 Club West Pkwy Ste 300 Blaine MN 55449-5861 |
| Mailing Address |
6625 Lyndale Ave S Ste 300 Minneapolis MN 55423-2491 |
| Practice Telephone | 6127888778 |
| Mailing Telephone | 6122008028 |
| Mailing Fax Number | 8882318658 |
| Enumeration Date | 2013-08-12 |
| Last Update Date | 2018-11-01 |
| Authorized Official Name | DR. BRYAN LEE MOHR (DR OF PODIATRY) |
| Authorized Official Telephone | 6122008028 |
| Authorized Official Credential | DPM |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
631 | MN | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Midwest Podiatry Centers | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164716387 | Active Feet, Foot & Ankle Health Center | Podiatrist | 4001 Stinson Blvd Ste 120, Minneapolis, MN 55421-3424 | 2011-06-06 |
| 1194158154 | Active Feet, Foot & Ankle Health Center | Clinic/Center | 6625 Lyndale Ave S Ste 105, Minneapolis, MN 55423-2673 | 2013-08-14 |
| 1689848392 | Active Feet, Foot & Ankle Health Center | Optometrist | 6625 Lyndale Ave S Ste 105, Minneapolis, MN 55423-2673 | 2008-04-15 |
| Street Address |
10995 CLUB WEST PKWY STE 300 |
| City | BLAINE |
| State | MN |
| Zip Code | 55449-5861 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033736368 | Landon Thomas Case | Dentist | 10729 Town Square Drive Ne, Ste 100, Blaine, MN 55449 | 2020-07-02 |
| 1881168441 | Ear Institutes, LLC | Otolaryngology | 4365 Pleasant Ridge Dr Ne, Suite 106, Blaine, MN 55449 | 2019-01-17 |
| 1841776242 | Kristin Broback | Nurse Practitioner | 10705 Town Square Dr Ne #100, Blaine, MN 55449 | 2018-07-18 |
| 1043719016 | Robin Lynn Broen | Registered Nurse | 3012 129th Ave Ne, Blaine, MN 55449 | 2018-02-06 |
| 1194197368 | Lund Health Professional Corporation | Chiropractor | 1360 101st Ave Ne, Suite 140, Blaine, MN 55449 | 2015-10-27 |
| 1871989806 | Blaine Wp II, LLC | Assisted Living Facility | 12402 Jamestown Street Ne, Blaine, MN 55449 | 2015-04-07 |
| 1154761633 | Jean Budge | Marriage & Family Therapist | 11800 Aberdeen Street Ne, Suite 100, Blaine, MN 55449 | 2013-06-28 |
| 1295013498 | Jeff K Yu | Veterinarian | 11850 Aberdeen St Ne, Blaine, MN 55449 | 2011-07-22 |
| 1528394707 | Julie Ann Eibensteiner | Physical Therapist | 11304 Davenport Circle Ne #a, Minneapolis, MN 55449 | 2009-10-23 |
| 1871725333 | Deborah Kathryn Zongo | Nurse Practitioner | 10190 Baltimore St Ne Ste 100, Blaine, MN 55449 | 2009-08-18 |
| Find all providers in zip 55449 | ||||
| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225158520 | Fridley Children's and Teenagers' Medical Center | Clinic/Center | 11107 Ulysses St Ne Ste 100, Blaine, MN 55434-4184 | 2007-03-30 |
| 1114124971 | Edina Eye Physicians and Surgeons Pa | Clinic/Center | 11855 Ulysses St, Suite 140, Blaine, MN 55434 | 2007-06-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922576081 | Complex Cares LLC | Clinic/Center | 4700 Lexington Ave N Ste C, Shoreview, MN 55126-5964 | 2018-11-07 |
| 1033565510 | Minnesota Disc Replacement and Spine Restoration Center | Clinic/Center | 4444 76 St, #700, Edina, MN 55435 | 2016-05-13 |
| 1992196307 | Austin Orthopedics & Sports Medicine | Clinic/Center | 14051 Burnhaven Dr Ste 100, Burnsville, MN 55337-4400 | 2015-02-08 |
| 1831599430 | Medifit Health, LLC | Clinic/Center | 9201 Quaday Ave Ne Ste 203, Otsego, MN 55330-6604 | 2014-09-02 |
| 1437567609 | Aligned Chiropractic Pa | Clinic/Center | 3408 E Lake St, Suite 120, Minneapolis, MN 55406-2175 | 2014-07-31 |
| 1316369911 | New Leaf Medical, Pllc | Clinic/Center | 3622 County Road 101 S, Wayzata, MN 55391-3424 | 2014-01-16 |
| 1841538808 | White Dandelion Chinese Medicine L.L.C. | Clinic/Center | 108 3rd St E, Northfield, MN 55057-2050 | 2013-01-27 |
| 1831409234 | Princeton Chiropractic Clinic LLC | Clinic/Center | 501 4th St S Ste 101, Princeton, MN 55371-4754 | 2010-10-19 |
| 1629252101 | Paula Allenburg, Ltd | Clinic/Center | 2415 Emerson Ave S, Minneapolis, MN 55405-2602 | 2007-12-20 |
| 1851516397 | Skin Care Doctors, P.a. | Clinic/Center | 14000 Nicollet Ave Ste 304, Burnsville, MN 55337-5784 | 2007-04-17 |
| 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.