NPIMap

Organization Active NPI

Fairview Health Services

  • Family Medicine Physician
  • Wyoming, MN
National Provider Identifier
1417037896
Registry record updated Feb 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
FAIRVIEW HEALTH SERVICES
Practice address
5200 Fairview Blvd
Wyoming, MN 55092-8013
Phone
(651) 982-7000
Fax
(651) 982-7110
NPI assigned
Oct 17, 2006
Last updated
Feb 24, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2025

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

Authorized official

Name
Maureen V Ring
Title
Sys Dir Govt Reimb & Netwk Rel
Phone
(612) 672-6740

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207P00000X
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X Primary
Internal Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207R00000X
Obstetrics & Gynecology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207V00000X
Hospitalist PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208M00000X
Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

5200 Fairview Blvd
Wyoming, MN 55092-8013

Mailing address

1700 University Ave W
Saint Paul, MN 55104-3727
Phone (612) 672-6740

Other names 1

  • Fairview Lakes Regional Medical Center - Physicians Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031105000461 MN Part B Supplier - Clinic/Group Practice 1951213057 Receives reassigned benefits from 4,101 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 256

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.

View all 256

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740355200000",
    "number": "1417037896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 UNIVERSITY AVE W",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551043727",
            "telephone_number": "612-672-6740",
            "fax_number": "612-884-3592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 FAIRVIEW BLVD",
            "city": "WYOMING",
            "state": "MN",
            "postal_code": "550928013",
            "telephone_number": "651-982-7000",
            "fax_number": "651-982-7110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRVIEW HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "status": "A",
        "authorized_official_last_name": "RING",
        "authorized_official_first_name": "MAUREEN",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "SYS DIR GOVT REIMB & NETWK REL",
        "authorized_official_telephone_number": "612-672-6740"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Hospitalist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fairview Lakes Regional Medical Center - Physicians",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Fairview Lakes Regional Medical Center - Physicians",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Wyoming, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.