Fairview Health Services
Organization Active NPI Prosthetic/Orthotic Supplier · Edina, MN
NPI 1770547796 · NPPES record last updated Jul 23, 2026
Key facts
- NPI
- 1770547796
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Prosthetic/Orthotic Supplier 335E00000X
- Legal business name
- FAIRVIEW HEALTH SERVICES
- Practice address
- 6545 France Ave S
Ste 450B
Edina, MN 55435-2131 - Phone
- (952) 929-7717
- Fax
- (952) 929-4535
- NPI assigned
- Apr 14, 2006
- Reactivated
- Feb 6, 2024
- Organization subpart
- No
Authorized official
- Name
- Jill Marie McCartney
- Title
- System Executive HME O&P
- Phone
- (651) 632-9835
Corporate family (same tax ID) 24
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
All facility ownership & control disclosures 4
| Facility | Type | Role | Since |
|---|---|---|---|
| Capitol Park Mental Health Hospital |
Hospital | 5% Or Greater Direct Ownership Interest (12.1%) | Dec 7, 2021 |
| Accentcare Fairview Home Health - East, LLC |
Home health agency | 5% Or Greater Indirect Ownership Interest (20%) | Nov 2, 2020 |
| Accentcare Fairview Home Health - West, LLC |
Home health agency | 5% Or Greater Indirect Ownership Interest (20%) | Nov 2, 2020 |
| Accentcare Fairview Hospice - West, LLC |
Hospice | 5% Or Greater Indirect Ownership Interest (20%) | Nov 2, 2020 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930051715 | MN | DME Supplier - Medical Supply Company With Orthotic-Prosthetic |
1951213057 | Practice locations: Edina, MN |
National Provider Directory
- Tax ID family
- Mesaba Clinic
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthetic/Orthotic Supplier | 335E00000X | Yes |
Addresses
Primary practice location
6545 France Ave S
Ste 450B
Edina, MN 55435-2131
Mailing address
1700 University Ave W
Saint Paul, MN 55104-3727
Phone (612) 672-7601
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 757615300 | Medicaid | MN | |
| 110289 | Other | MN | UCARE |
| 8200173 | Other | MN | MEDICA |
| 8253 | Other | MN | HEALTHPARTNERS |
| 67Q55FA | Other | MN | BCBS |
Other names
- Fairview Edina Orthotics and Prosthetics
- Fairview Orthotics and Prosthetics
NPI Registry JSON
{
"created_epoch": "1144972800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1784764800000",
"number": "1770547796",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1700 UNIVERSITY AVE W",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551043727",
"telephone_number": "612-672-7601",
"fax_number": "612-884-3592"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6545 FRANCE AVE S",
"address_2": "STE 450B",
"city": "EDINA",
"state": "MN",
"postal_code": "554352131",
"telephone_number": "952-929-7717",
"fax_number": "952-929-4535"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FAIRVIEW HEALTH SERVICES",
"organizational_subpart": "NO",
"enumeration_date": "2006-04-14",
"last_updated": "2026-07-23",
"certification_date": "2026-07-23",
"deactivation_date": "2023-10-04",
"reactivation_date": "2024-02-06",
"status": "A",
"authorized_official_last_name": "MCCARTNEY",
"authorized_official_first_name": "JILL",
"authorized_official_middle_name": "MARIE",
"authorized_official_title_or_position": "SYSTEM EXECUTIVE HME O&P",
"authorized_official_telephone_number": "651-632-9835"
},
"taxonomies": [
{
"code": "335E00000X",
"taxonomy_group": "",
"desc": "Prosthetic/Orthotic Supplier",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "757615300",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UCARE",
"identifier": "110289",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA",
"identifier": "8200173",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHPARTNERS",
"identifier": "8253",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "67Q55FA",
"state": "MN"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Fairview Edina Orthotics and Prosthetics",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Fairview Orthotics and Prosthetics",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Fairview Orthotics and Prosthetics",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Edina, MN
- Fairview Express Care
- Fairview Health Servcies
- Fairview Health Services
- Fairview Health Services
- Fairview Health Services
- Fairview Health Services
- Fairview Health Services
- Fairview Health Services
- Fairview Health Services
- Fairview Pharmacy Service LLC
All providers in Edina, MN · Prosthetic/Orthotic Supplier in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 23, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.