St. David'S Center

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

ST. DAVID'S CENTER

Practice address

3395 Plymouth Rd
Minnetonka, MN 55305-3765

Phone

(952) 548-8618

NPI assigned

Jun 30, 2008

Organization subpart

No

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

Authorized official

Name

Julie Sjordal

Title

Ceo

Phone

(952) 939-0396

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 2

• St. David's Center for Child & Family Development Doing business as
• St. David's Child Development & Family Services Former legal business name

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• St. David'S Center

  • Rehabilitation Clinic/Center
  • Minnetonka, MN
  • NPI 1376752337

  O20140617000717

  Same enrollment

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Madelyn Hudlow, OTD, OTR/L

  • Occupational Therapist
  • Minneapolis, MN
  • NPI 1699666370
  NPD
• Brianna Elizabeth Hoyt, OTR/L

  • Occupational Therapist
  • South Bend, IN
  • NPI 1639862113
  NPD
• Stephanie Abbas, MSW, LICSW

  • Social Worker
  • Minneapolis, MN
  • NPI 1942736079
  NPD (past)

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

{
    "created_epoch": "1214784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649289600000",
    "number": "1487816468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3395 PLYMOUTH RD",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553053765",
            "telephone_number": "952-548-8618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3395 PLYMOUTH RD",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553053765",
            "telephone_number": "952-548-8618"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 Marquette Ave",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554032419",
            "country_code": "US",
            "telephone_number": "952-939-0396",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ST. DAVID'S CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-30",
        "last_updated": "2022-04-07",
        "certification_date": "2022-04-07",
        "status": "A",
        "authorized_official_last_name": "SJORDAL",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "952-939-0396"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "644218800",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. David's Center for Child & Family Development",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "St. David's Child Development & Family Services",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Cindy Lou Sprau, CNP
• Brett Robert Springsted, PMHNP-BC
• Mary Elizabeth Spurlock, APRN
• St John Home Care
• St. David'S Center
• St. David'S Center
• St. David'S Center
• Stephanie Stackhouse, M.D.
• Stacy Vancura Counseling
• Victoria Joan Stadnyk, FNP

• Community/Behavioral Health Agency in Minnetonka, MN
• Providers in Minnetonka, MN by specialty
• Community/Behavioral Health Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2022; 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.