Active NPI
Mary Eaton, M.D.
- Pediatrics Physician
- Edina, MN
National Provider Identifier
1467466342
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 39557
- Practice address
- 6545 France Ave S
Suite 400
Edina, MN 55435-2131 - Phone
- (952) 920-9191
- Fax
- (952) 920-0232
- NPI assigned
- Jul 28, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 39557 | MN | Primary |
Addresses
Primary practice location
6545 France Ave S
Suite 400
Edina, MN 55435-2131
Mailing address
6545 France Ave S
Suite 400
Edina, MN 55435-2131
Phone (952) 920-9191
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CP9021014034 | Other | PREFERRED ONE | |
| 1200232 | Other | MEDICA | |
| 04R24EA | Other | MN | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39557 | MN | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fairview Health Services | Past | Accepting new patients | |
| Metropolitan Pediatric Specialists, P.a. | Past | Accepting new patients |
Interoperability endpoints
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Acute Care Hospital
- Edina, MN
- NPI 1699752915
-
- Clinic/Center
- Edina, MN
- NPI 1558459206
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1467466342",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6545 FRANCE AVE S",
"address_2": "SUITE 400",
"city": "EDINA",
"state": "MN",
"postal_code": "554352131",
"telephone_number": "952-920-9191",
"fax_number": "952-920-0232"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6545 FRANCE AVE S",
"address_2": "SUITE 400",
"city": "EDINA",
"state": "MN",
"postal_code": "554352131",
"telephone_number": "952-920-9191",
"fax_number": "952-920-0232"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EATON",
"first_name": "MARY",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MN",
"license": "39557",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED ONE",
"identifier": "CP9021014034",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA",
"identifier": "1200232",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "04R24EA",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Edina, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.