Foundational Evolutions LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

FOUNDATIONAL EVOLUTIONS LLC

Practice address

20720 187TH Ave NW
Big Lake, MN 55309-9388

Phone

(612) 499-2816

NPI assigned

Apr 27, 2017

Last updated

Apr 27, 2017By 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

Heather J O'Neal

Title

President

Phone

(612) 499-2816

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1493251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493251200000",
    "number": "1508391590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1265",
            "city": "MONTICELLO",
            "state": "MN",
            "postal_code": "553621265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20720 187TH AVE NW",
            "city": "BIG LAKE",
            "state": "MN",
            "postal_code": "553099388",
            "telephone_number": "612-499-2816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUNDATIONAL EVOLUTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-27",
        "last_updated": "2017-04-27",
        "status": "A",
        "authorized_official_last_name": "O'NEAL",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "612-499-2816"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Ann Dill, DDS
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• Jodi Leigh Donnay, MA LMFT
• Beth K Drager, PT
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• Fresenius Medical Care Centracare Dialysis, LLC (Fresenius Kidney Care Big Lake)
• Tricia Gallup, PT
• Amy Ann Glanz
• Donna Gotzian, RN
• Rachel Suzanne Gupta, R.N., B.S.N

• Community/Behavioral Health Agency in Big Lake, MN
• Providers in Big Lake, 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 27, 2017; 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.