Mount Olivet Home

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

License

328408 Issued in MN

Legal business name

MOUNT OLIVET HOME

Practice address

5517 Lyndale Ave S
Minneapolis, MN 55419-1719

Phone

(612) 827-5677

Fax

(612) 821-3241

NPI assigned

Jul 19, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Richard A Anderson

Title

Controller

Phone

(612) 821-3185

Specialties & licenses 1

Addresses

Practitioners 3

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

• Janet L Bijwadia, M.D.

  • Internal Medicine Physician
  • Minneapolis, MN
  • NPI 1346420916
  NPD (past)
• Gretchen Cole, MD

  • Internal Medicine Physician
  • Edina, MN
  • NPI 1942279575
  NPD (past)
• William Joseph Hamilton, MD

  • Family Medicine Physician
  • Minneapolis, MN
  • NPI 1194715748
  NPD (past)

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1619976974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5517 LYNDALE AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554191719",
            "telephone_number": "612-827-5677",
            "fax_number": "612-821-3241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5517 LYNDALE AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554191719",
            "telephone_number": "612-827-5677",
            "fax_number": "612-821-3241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNT OLIVET HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "612-821-3185",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "MN",
            "license": "328408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Nicole Mould, PA-C
• Maleta Kihm Moulsoff, DO
• Laura Marie Moulton Sutherland
• Mount Olivet Careview Home
• Mount Olivet Day Services
• Mountnirecare
• Andrea Ellen Mousel, MA, LMFT
• Daphne Moutsoglou, MD
• Sabrin Mowlid
• Moxie Incorporated

• Nursing Facility/Intermediate Care Facility in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Nursing Facility/Intermediate Care Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.