North Star Podiatric Laboratories Inc.

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

NORTH STAR PODIATRIC LABORATORIES INC.

Practice address

7400 Lyndale Ave S Ste 160
Richfield, MN 55423-4142

Phone

(651) 353-5845

Fax

(612) 224-9457

NPI assigned

Sep 13, 2017

Organization subpart

Yes

Parent organization

1962409995As reported in NPPES

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

Authorized official

Name

Mrs. Teresa Ann Wagner, CERTIFIED PEDORTHIST

Title

President

Phone

(651) 426-9388

Specialties & licenses 2

Addresses

Part of

North Star Podiatric Laboratories Inc

Locations

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

{
    "created_epoch": "1505260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508889600000",
    "number": "1801315650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13419 FENWAY BLVD N STE 101",
            "city": "HUGO",
            "state": "MN",
            "postal_code": "550387466",
            "telephone_number": "651-426-9388",
            "fax_number": "651-426-7450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7400 LYNDALE AVE S STE 160",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554234142",
            "telephone_number": "651-353-5845",
            "fax_number": "612-224-9457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH STAR PODIATRIC LABORATORIES INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "1962409995",
        "enumeration_date": "2017-09-13",
        "last_updated": "2017-10-25",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "TERESA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "651-426-9388",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CERTIFIED PEDORTHIST"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tran Bao Nguyen, DPM
• Junaid Niazi, MD, MPH
• Karli Nielsen
• Claire Niessen-Derry, MSW, LICSW
• Karin Kongsjord Nikula, EDD/CCC-SLP
• Northland Dental Partners, PLLC
• Nova Health Inc
• Novacare Outpatient Rehabilitation East, Inc.
• Nurkay Inc
• Bridget Duffy O'Connor, MSW, LICSW

• Prosthetic/Orthotic Supplier in Richfield, MN
• Providers in Richfield, MN by specialty
• Prosthetic/Orthotic Supplier in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 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.