FMG Country Club Drive Minnesota LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

FMG COUNTRY CLUB DRIVE MINNESOTA LLC

Doing business as

Golden Valley Rehabilitation and Care Center

Practice address

7505 Country Club Dr
Golden Valley, MN 55427-4501

Phone

(763) 450-6900

Fax

(763) 545-2016

NPI assigned

Dec 18, 2014

Last updated

Dec 23, 2014By 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

David Keating

Title

Authorized Official

Phone

(414) 908-8058

Specialties & licenses 1

Addresses

Other names 1

• Golden Valley Rehabilitation and Care Center Doing business as

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

{
    "created_epoch": "1418860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419292800000",
    "number": "1477951747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7505 COUNTRY CLUB DR",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554274501",
            "telephone_number": "763-450-6900",
            "fax_number": "763-545-2016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7505 COUNTRY CLUB DR",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554274501",
            "telephone_number": "763-450-6900",
            "fax_number": "763-545-2016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FMG COUNTRY CLUB DRIVE MINNESOTA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-18",
        "last_updated": "2014-12-23",
        "status": "A",
        "authorized_official_last_name": "KEATING",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "414-908-8058"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Golden Valley Rehabilitation and Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ferris Ann Fletcher, PHD
• Dennis Lee Flom, MA
• Elizabeth Jeanne Florin, COTA
• Daniel F Flynn, MSW
• Jessica M Flynn, LICSW
• Folske Spine & Rehab Clinic
• Wade K Folske, DC
• Benjamin Hughes Forsberg, MA, LMFT
• Katelyn R Forsell, NP
• Forward Spine Center LLC (Forward Spine Center)

• Skilled Nursing Facility in Golden Valley, MN
• Providers in Golden Valley, MN by specialty
• Skilled Nursing Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.