NPIMap

Organization Active NPI

Peach State Medical Practice, PC

Doing business as Kindbody of MN Medical Practice, PC

  • Reproductive Endocrinology Physician
  • Minneapolis, MN
National Provider Identifier
1841967825
Registry record updated May 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Reproductive Endocrinology PhysicianTaxonomy code 207VE0102X
Legal business name
PEACH STATE MEDICAL PRACTICE, PC
Doing business as
Kindbody of MN Medical Practice, PC
Practice address
138 N 2ND St
Minneapolis, MN 55401
Phone
(855) 563-2639
NPI assigned
Aug 26, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2024

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

Authorized official

Name
Dr. Fahimeh Sasan, DONPI 1306005145
Title
Founding Obgyb
Phone
(855) 563-2639

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Reproductive Endocrinology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207VE0102X Primary

Addresses

Primary practice location

138 N 2ND St
Minneapolis, MN 55401

Mailing address

333 S Desplaines St Ste 201
Chicago, IL 60661-5514
Phone (855) 563-2639

Other names 1

  • Kindbody of MN Medical Practice, PC Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
24D2232808Peach State Medical Practice, PC138 North Second Street, Minneapolis, MN 55401AccreditationOct 25, 2026

National Provider Directory

National Provider Directory
Tax ID family
Peach State Medical Practice PC12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1629936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716163200000",
    "number": "1841967825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 S DESPLAINES ST STE 201",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606615514",
            "telephone_number": "855-563-2639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 N 2ND ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55401",
            "telephone_number": "855-563-2639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACH STATE MEDICAL PRACTICE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-26",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A",
        "authorized_official_last_name": "SASAN",
        "authorized_official_first_name": "FAHIMEH",
        "authorized_official_title_or_position": "FOUNDING OBGYB",
        "authorized_official_telephone_number": "855-563-2639",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207VE0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kindbody of MN Medical Practice, PC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kindbody of MN Medical Practice, PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.