FMG WEST 36 1/2 STREET MINNESOTA LLC (NPI# 1861884199) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861884199 |
| Entity Type | Organization |
| Organization Name | FMG WEST 36 1/2 STREET MINNESOTA LLC |
| Other Organization Name | PARK HEALTH & REHABILITATION |
| Practice Address |
4415 W 36 1/2 St St Louis Park MN 55416-4854 |
| Practice Telephone | 9529279717 |
| Mailing Telephone | 9529279717 |
| Enumeration Date | 2015-02-24 |
| Last Update Date | 2015-02-24 |
| Authorized Official Name | DAVID KEATING (AUTHORIZED OFFICIAL) |
| Authorized Official Telephone | 4149088058 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Park Health & Rehabilitation | Doing Business As Name - Organization |
| Street Address |
4415 W 36 1/2 ST |
| City | ST LOUIS PARK |
| State | MN |
| Zip Code | 55416-4854 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184798712 | Extendicare Homes, Inc. | Skilled Nursing Facility | 4415 W 36 1/2 St, St Louis Park, MN 55416-4854 | 2006-11-17 |
| 1215446786 | St. Louis Park Opco II, LLC | Skilled Nursing Facility | 4415 W 36 1/2 St, St Louis Park, MN 55416-4854 | 2017-09-27 |
| 1235502337 | Emily Miller | Physical Therapy Assistant | 4415 W 36 1/2 St, St Louis Park, MN 55416-4854 | 2015-11-11 |
| 1083095749 | Mary Ann Em | Physical Therapist | 4415 W 36 1/2 St, St Louis Park, MN 55416-4854 | 2015-06-17 |
| 1952729246 | Richard Joshua Mester | Occupational Therapy Assistant | 4415 W 36 1/2 St, St Louis Park, MN 55416-4854 | 2014-04-03 |
| 1699110528 | Anthony Lane | Occupational Therapist | 4415 W 36 1/2 St, St Louis Park, MN 55416-4854 | 2013-05-06 |
| 1023453123 | Malia L King | Physical Therapy Assistant | 4415 W 36 1/2 St, St Louis Park, MN 55416-4854 | 2013-05-02 |
| 1568807634 | Martha Kristin Sawyer | Skilled Nursing Facility | 4415 W 36 1/2 St, St Louis Park, MN 55416-4854 | 2013-05-02 |
| 1639423809 | Thomas Heifner | Physical Therapy Assistant | 4415 W 36 1/2 St, St Louis Park, MN 55416-4854 | 2012-11-09 |
| 1720332083 | Kelsey Christine Moyer | Physical Therapy Assistant | 4415 W 36 1/2 St, St Louis Park, MN 55416-4854 | 2012-11-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639711492 | Ismahan Abdirahman Mohamed | Psychologist | 4236 Parkglen Rd, St Louis Park, MN 55416 | 2019-10-14 |
| 1598307860 | Ayman Abulaziz Mohamed | Counselor | 4326 Park Glen Rd, St Louis Park, MN 55416 | 2019-10-08 |
| 1831758929 | Ally Group Homes LLC | Assisted Living Facility | 2944 Princeton Ave South, Saint Louis Park, MN 55416 | 2019-06-11 |
| 1609371525 | Heather Margaret Flatgard | Chiropractor | 5407 Excelsior Blvd Ste D, St Louis Park, MN 55416 | 2018-03-25 |
| 1942702394 | Polaris Pharmacy Services of Minnesota, LLC | Pharmacy | 4220 Park Glen Road, St. Louis Park, MN 55416 | 2018-03-01 |
| 1316469760 | Evert Ray Boyd | Psychologist | 3200 Highway 100 S., Groves Academy, St Louis Park, MN 55416 | 2017-07-07 |
| 1861941684 | Amanda Marie Tapper | Marriage & Family Therapist | 5407 Excelsior Blvd, Suite B, St Louis Park, MN 55416 | 2016-09-22 |
| 1326410416 | Clear Health Chiropractic LLC | Chiropractor | 5614 W 36th St, St. Louis Park, MN 55416 | 2015-10-28 |
| 1568897833 | Kay Elizabeth Lichtenberger | Physical Therapist | 4415 W 36.5 St, St. Louis Park, MN 55416 | 2013-09-05 |
| 1710221510 | Aaron Christopher Oppelt | Counselor | 1665 Utica Ave South - Suite 100, Saint Louis Park, MN 55416 | 2012-11-16 |
| Find all providers in zip 55416 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194156034 | Sheron Home Health Care, LLC | Skilled Nursing Facility | 2480 Highway 100 S, Apt 132, St Louis Park, MN 55416-1762 | 2013-12-03 |
| 1184798712 | Extendicare Homes, Inc. | Skilled Nursing Facility | 4415 W 36 1/2 St, St Louis Park, MN 55416-4854 | 2006-11-17 |
| 1578635082 | Extendicare Homes, Inc. | Skilled Nursing Facility | 7900 W 28th St, St Louis Park, MN 55426-3011 | 2006-11-14 |
| 1932150380 | Ggnsc Minneapolis St. Louis Park LLC | Skilled Nursing Facility | 3201 Virginia Ave S, St Louis Park, MN 55426-3624 | 2006-05-12 |
| 1770560005 | Sholom Home West Inc | Skilled Nursing Facility | 3620 Phillips Pkwy, St Louis Park, MN 55426-3700 | 2005-12-28 |
| 1336133990 | Aviv Health Care, Inc. | Skilled Nursing Facility | 7500 W 22nd St, St Louis Park, MN 55426-2602 | 2005-09-09 |
| 1417466970 | St. Louis Park Opco, LLC | Skilled Nursing Facility | 7900 W 28th St, St Louis Park, MN 55426-3011 | 2017-09-27 |
| 1215446786 | St. Louis Park Opco II, LLC | Skilled Nursing Facility | 4415 W 36 1/2 St, St Louis Park, MN 55416-4854 | 2017-09-27 |
| 1689112153 | Estates At St Louis Park LLC | Skilled Nursing Facility | 3201 Virginia Ave S, St Louis Park, MN 55426-3624 | 2017-02-06 |
| 1679965909 | Fmg West 28th Street Minnesota LLC | Skilled Nursing Facility | 7900 W 28th St, St Louis Park, MN 55426-3011 | 2015-02-24 |
| Find all providers in ST LOUIS PARK | ||||
| City | ST LOUIS PARK |
| Zip Code | 55416 |
Please comment or provide details below to improve the information on FMG WEST 36 1/2 STREET MINNESOTA LLC.
| 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.