PHOENIX (NPI# 1972118438) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972118438 |
| Entity Type | Organization |
| Organization Name | PHOENIX |
| Practice Address |
6697 Elm St North Branch MN 55056-7045 |
| Practice Telephone | 6517958759 |
| Mailing Telephone | 6517958759 |
| Enumeration Date | 2020-09-11 |
| Last Update Date | 2020-09-11 |
| Authorized Official Name | JEREMY JAMES KORTUS (CO-FOUNDER) |
| Authorized Official Telephone | 6517958759 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251V00000X | Voluntary or Charitable | Agencies |
| Other Name | Type Code |
|---|---|
| Phoenix | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | PHOENIX | 17965 Dumfries Shopping Plz # 201e Dumfries, Dumfries, VA 22026-2327 |
| Colorado Business Entities | Phoenix Evaluation and Design LLC | 15323 Heritage Circle, Thornton, CO 80602 |
| Oklahoma Business Registrations | PHOENIX & ASSOCIATES LLC | 12115 S 101st E Ave, Bixby, OK 74008 |
| Colorado Business Entities | PHOENIX & ASSOCIATES, LLC | 23935 Sweet Rd, Calhan, CO 80808 |
| Massachusetts Corporations | PHOENIX & DRAGON FOODS CORP. | 113 Hancock Street, Newton, MA 02466 |
| Oregon Corporations, Companies and Business Names | PHOENIX & FOXX LLC | 1385 Sw Broadway Drive, Portland, OR 97201 |
| Oregon Corporations, Companies and Business Names | PHOENIX & HOLLY RAILROAD, INC. | 2512 N Holly St, Canby, OR 97013 |
| Vermont Business Registrations | PHOENIX & SON CONSTRUCTION, LLC | 144 Creamery Street, Marshfield, VT 05658 |
| New York State Corporations | PHOENIX & WOLF GAMING, LLC | P.o. Box 2968, Schenectady, Ny 12325 |
| System for Award Management (SAM) Entities | PHOENIX (21) CORPORATION | 2232 Phoenix Ave, Davie, FL 33324-6316 |
| Street Address |
6697 ELM ST |
| City | NORTH BRANCH |
| State | MN |
| Zip Code | 55056-7045 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306217146 | Joy Solano | Counselor | 38873 14th Ave North, North Branch, MN 55056 | 2015-10-19 |
| 1285072637 | Teresa Ann Dewitt | Registered Nurse | 9208 St Croix Trail, North Branch, MN 55056 | 2013-06-07 |
| 1396074209 | Twin Cities Mobile Chiropractic, P.C. | Clinic/Center | 6754 380th Circle, North Branch, MN 55056 | 2009-12-24 |
| 1811157662 | Shopko Stores Operating Co LLC | Pharmacy | 5630 St Croix Trail, North Branch, MN 55056 | 2008-06-16 |
| 1023171196 | Shawn Timothy Mccullough | Dentist | 6041 Main Street, Suite C, North Branch, MN 55056 | 2006-12-19 |
| 1518050103 | Paula J Rehder | Family Medicine | 6413 Oak Street, North Branch, MN 55056 | 2006-10-02 |
| 1699711614 | Julie A Perreault | Chiropractor | 6361 Main St, No Branch, MN 55056 | 2006-06-20 |
| 1760950307 | Kara H Mireles | Marriage & Family Therapist | 5842 Old Main St, Ste 2,3,4, North Branch, MN 55056 | 2018-11-12 |
| 1134614506 | Jenna Marie Leirmoe | Counselor | 38878 12th Ave, North Branch, MN 55056 | 2018-06-27 |
| 1689835647 | Shopko Stores Operating Co LLC | Eyewear Supplier (Equipment, not the service) | 5630 St Croix Trail, North Branch, MN 55056 | 2008-06-23 |
| Find all providers in zip 55056 | ||||
| Taxonomy Code | 251V00000X |
| Grouping | Agencies |
| Classification | Voluntary or Charitable |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063585529 | Outlook Health Services, Inc. | Voluntary or Charitable | 6413 Oak St, North Branch, MN 55056-5129 | 2006-11-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174140925 | Community Integrated Family Care Advocates | Voluntary or Charitable | 11114 Almond Dr, Grey Eagle, MN 56336-4643 | 2020-06-28 |
| 1235764465 | Age Well Arrowhead Inc. | Voluntary or Charitable | 306 W Superior St Ste 10, Duluth, MN 55802-5025 | 2020-03-09 |
| 1316476864 | Changing Gaits Inc. | Voluntary or Charitable | 27274 Monument Rd, Brook Park, MN 55007-2196 | 2017-06-08 |
| 1386189801 | On-site Dentistry | Voluntary or Charitable | 7600 France Ave. S., Suite 1100, Edina, MN 55130-5924 | 2016-12-20 |
| 1659822286 | Floodwood Services & Training, Inc. | Voluntary or Charitable | 601 Ash St, Floodwood, MN 55736-8177 | 2016-10-19 |
| 1598215295 | Faith In Action for Cass County | Voluntary or Charitable | 120 Whipple Ave E, Suite B, Hackensack, MN 56452 | 2016-10-06 |
| 1740639814 | Expresslanguageservices | Voluntary or Charitable | 1116 Deerwood Ln, Faribault, MN 55021-1921 | 2016-06-08 |
| 1730582024 | Amira Ahmed | Voluntary or Charitable | 308 Prince St Ste 258, Saint Paul, MN 55101-1437 | 2014-10-01 |
| 1154737278 | Deaf & Immigrant Center for Education | Voluntary or Charitable | 3708 36th Ave S, Minneapolis, MN 55406-2756 | 2014-07-09 |
| 1669801429 | Child Care Choices, Inc. | Voluntary or Charitable | 2901 Clearwater Rd, Saint Cloud, MN 56301-5950 | 2013-11-02 |
| Find all providers with the same taxonomy | ||||
| City | NORTH BRANCH |
| Zip Code | 55056 |
Please comment or provide details below to improve the information on PHOENIX.
| 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.