Fraser

Primary specialty

Rehabilitation Clinic/CenterTaxonomy code 261QR0400X

Legal business name

FRASER

Practice address

2400 W 64TH St
Richfield, MN 55423-1001

Phone

(612) 861-1688

Fax

(612) 861-6050

NPI assigned

Jan 26, 2007

Last updated

Aug 12, 2021By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. James D Olson

Title

Chief Financial Officer

Phone

(612) 798-8320

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1063568574. Details of each certification follow.

• CCN 246615 Outpatient physical therapy / speech pathology · Active · Name & address match · Details

Outpatient physical therapy / speech pathology certification: CCN 246615

Legal name

FRASER RICHFIELD

Certification status

Active

Provider type (POS)

Outpatient physical therapy / speech pathology

Participating since

Oct 29, 2018

Last certification

Jun 5, 2018

Ownership / control type

Voluntary Non-Profit Other Than Church

Facility address

2400 West 64TH Street
Richfield, MN 55423

Locations

Practitioners 1,279

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ikran Faisal Abdi

  • Behavior Technician
  • Woodbury, MN
  • NPI 1740176064
  NPD (past)
• Layla Ali Abdi, LICSW

  • Clinical Social Worker
  • Minneapolis, MN
  • NPI 1356899124
  NPD (past)
• Shuayb Abdi

  • Behavior Technician
  • Bloomington, MN
  • NPI 1639097017
  NPD (past)
• Asha Abdikadir

  • Behavior Technician
  • Minneapolis, MN
  • NPI 1538827654
  NPD (past)
• Sabarin K Abdikadir

  • Behavior Technician
  • Bloomington, MN
  • NPI 1912792425
  NPD (past)
• Yasmiin Shakur Abdinur

  • Behavior Technician
  • Bloomington, MN
  • NPI 1871286542
  NPD (past)
• Nisreen Abdelmuti Abuhadid

  • Clinical Social Worker
  • Minneapolis, MN
  • NPI 1538980370
  NPD (past)
• Frances Carolyn Adair, LICSW

  • Clinical Social Worker
  • Minneapolis, MN
  • NPI 1790197002
  NPD (past)
• Fahima Mohamed Adam

  • Behavior Technician
  • Bloomington, MN
  • NPI 1265193700
  NPD (past)
• Hayyat Muhamoud Adam

  • Behavior Technician
  • Eden Prairie, MN
  • NPI 1942819198
  NPD (past)
• Jessica Ann Adams, MS, BCBA

  • Behavior Analyst
  • Coon Rapids, MN
  • NPI 1396305595
  NPD (past)
• Ayan Hassan Adan

  • Behavior Technician
  • Eden Prairie, MN
  • NPI 1689168676
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628726400000",
    "number": "1063568574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 W 64TH ST",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554231001",
            "telephone_number": "612-861-1688",
            "fax_number": "612-861-6050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 W 64TH ST",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554231001",
            "telephone_number": "612-861-1688",
            "fax_number": "612-861-6050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRASER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-26",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A",
        "authorized_official_last_name": "OLSON",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "612-798-8320",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "166355100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Forte Chiropractic Clinic PA
• Mary Lee Forte, DC
• Kimberly M Fowler
• Anna Fox, LMFT
• Sara Lorraine Fox, SLP
• Melanie Fredette, D.M.D.
• Ann Marie Freeman, MA
• Erin Frey
• Laura Frisby
• Gabal Care Services LLC

• Rehabilitation Clinic/Center in Richfield, MN
• Providers in Richfield, MN by specialty
• Rehabilitation Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.