FMG West 36 1/2 Street Minnesota LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

FMG WEST 36 1/2 STREET MINNESOTA LLC

Doing business as

Park Health & Rehabilitation

Practice address

4415 W 36 1/2 St
St Louis Park, MN 55416-4854

Phone

(952) 927-9717

NPI assigned

Feb 24, 2015

Organization subpart

No

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

Authorized official

Name

David Keating

Title

Authorized Official

Phone

(414) 908-8058

Specialties & licenses 1

Addresses

Other names 1

• Park Health & Rehabilitation Doing business as

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

{
    "created_epoch": "1424736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424736000000",
    "number": "1861884199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4415 W 36 1/2 ST",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554164854",
            "telephone_number": "952-927-9717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4415 W 36 1/2 ST",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554164854",
            "telephone_number": "952-927-9717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FMG WEST 36 1/2 STREET MINNESOTA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-24",
        "last_updated": "2015-02-24",
        "status": "A",
        "authorized_official_last_name": "KEATING",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "414-908-8058"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Park Health & Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kaelee Rose Flettree
• Julie Ruth Flores, RD, LD
• Adaja Flowers
• Katherine Jane Flynn, LPC, LADC
• FMG West 28TH Street Minnesota LLC (Texas Terrace Care Center)
• Elaine Foell
• Dureeti H Foge, MD
• Lauren B Fogel Mersy, PSYD
• Denis Folan, DO
• Chirstopher James Foley, DC

• Skilled Nursing Facility in St Louis Park, MN
• Providers in St Louis Park, MN by specialty
• Skilled Nursing Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2015; 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.