Active NPI
St. David'S Center
- Case Management Agency
- Minnetonka, MN
National Provider Identifier
1851553838
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Management Agency
- Legal business name
- ST. DAVID'S CENTER
- Practice address
- 3395 Plymouth Rd
Minnetonka, MN 55305-3765 - Phone
- (952) 548-8618
- NPI assigned
- Jun 30, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Julie Sjordal
- Title
- Ceo
- Phone
- (952) 939-0396
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Management Agency | 251B00000X | Primary | ||
| Early Intervention Provider Agency | 252Y00000X |
Addresses
Primary practice location
3395 Plymouth Rd
Minnetonka, MN 55305-3765
Mailing address
3395 Plymouth Rd
Minnetonka, MN 55305-3765
Phone (952) 548-8618
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 644218804 | Medicaid | MN |
Other names 2
- St. David's Center for Child & Family Development
- St Davids Child Development & Family Services
National Provider Directory
National Provider Directory- Tax ID family
- MN St Davids Center
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Rehabilitation Clinic/Center
- Minnetonka, MN
- NPI 1376752337
Locations
3395 Plymouth Rd
Minnetonka, MN 55305
Phone (952) 939-0396
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214784000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1649289600000",
"number": "1851553838",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3395 PLYMOUTH RD",
"city": "MINNETONKA",
"state": "MN",
"postal_code": "553053765",
"telephone_number": "952-548-8618"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3395 PLYMOUTH RD",
"city": "MINNETONKA",
"state": "MN",
"postal_code": "553053765",
"telephone_number": "952-548-8618"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ST. DAVID'S CENTER",
"organizational_subpart": "NO",
"enumeration_date": "2008-06-30",
"last_updated": "2022-04-07",
"certification_date": "2022-04-07",
"status": "A",
"authorized_official_last_name": "SJORDAL",
"authorized_official_first_name": "JULIE",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "952-939-0396"
},
"taxonomies": [
{
"code": "251B00000X",
"taxonomy_group": "",
"desc": "Case Management",
"state": null,
"license": null,
"primary": true
},
{
"code": "252Y00000X",
"taxonomy_group": "",
"desc": "Early Intervention Provider Agency",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "644218804",
"state": "MN"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "St. David's Center for Child & Family Development",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "St Davids Child Development & Family Services",
"code": "4",
"type": "Former Legal Business Name"
}
]
}Other providers in Minnetonka, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 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.