NPIMap

Eagan Valley Pediatrics, P.a.

Organization Active NPI Clinic/Center · Apple Valley, MN

NPI 1528050119 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1528050119
Entity type
Organization (NPI type 2)
Primary specialty
Clinic/Center 261Q00000X
Legal business name
EAGAN VALLEY PEDIATRICS, P.A.
Practice address
14135 Cedar Ave
Suite 100
Apple Valley, MN 55124-4522
Phone
(952) 432-4373
Fax
(952) 997-5679
NPI assigned
Aug 19, 2005
Organization subpart
No

Authorized official

Name
James E Dufort, M.D. NPI 1376535732
Title
President
Phone
(952) 432-4373

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 12

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

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
24D0978828Eagan Valley Pediatrics
14135 Cedar Ave, Apple Valley, MN 55124		ComplianceOct 29, 2026

National Provider Directory

Locations

14135 Cedar Ave
Ste 100
Apple Valley, MN 55124
Phone (952) 432-4373

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Yes

Addresses

Primary practice location

14135 Cedar Ave
Suite 100
Apple Valley, MN 55124-4522

Mailing address

14135 Cedar Ave
Suite 100
Apple Valley, MN 55124-4522
Phone (952) 432-4373

Other providers in Apple Valley, MN

All providers in Apple Valley, MN · Clinic/Center in Minnesota

Sources for this page

Verify at the official NPI Registry.