Thomas Joseph Gendron, CNOR, OPA-C

Primary specialty

Registered Nurse First AssistantTaxonomy code 163WR0006X

License

1110737 Issued in MN

Practice address

775 Prairie Center Dr
Suite 250
Eden Prairie, MN 55344-7314

Phone

(952) 944-2519

Fax

(952) 944-0460

NPI assigned

Aug 24, 2006

Last updated

May 24, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653350400000",
    "number": "1659488625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6465 WAYZATA BLVD",
            "address_2": "SUITE 900",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554261728",
            "telephone_number": "952-512-5600",
            "fax_number": "952-512-5650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "775 PRAIRIE CENTER DR",
            "address_2": "SUITE 250",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553447314",
            "telephone_number": "952-944-2519",
            "fax_number": "952-944-0460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENDRON",
        "first_name": "THOMAS",
        "middle_name": "JOSEPH",
        "credential": "CNOR, OPA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2022-05-24",
        "certification_date": "2022-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WR0006X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "MN",
            "license": "1110737",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "55A73GE",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERREDONE",
            "identifier": "969991001287",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "HP49823",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thomas Andrew Gebhard, M.D.
• Jacob Gebrael, MD
• VI Geeraerts
• Mohamed Aden Geire
• Cynthia Gellner, PHARM D
• Kevin Robert Gennrich, DPT
• Genoa Healthcare LLC
• Annika Minnie Gensmer
• Roberta Lynn Gerling, PSYD, LP
• Elaina Charlotte Gerst

• Registered Nurse First Assistant in Eden Prairie, MN
• Providers in Eden Prairie, MN by specialty
• Registered Nurse First Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2022; 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.