Elizabeth Joan Fazendin, D.O

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

49301 Issued in MN

Practice address

1 Veterans Dr
Department of PM&R - VA Medical Center
Minneapolis, MN 55417-2309

Phone

(612) 725-2000

NPI assigned

Jun 26, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Minnesota Head and Neck Pain Clinic, PA

  • Specialist
  • St Paul, MN
  • NPI 1104850155
  NPD (past)

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

{
    "created_epoch": "1182816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881890747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3320 FRANCE AVE S",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554164713",
            "telephone_number": "612-396-5980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 VETERANS DR",
            "address_2": "DEPARTMENT OF PM&R - VA MEDICAL CENTER",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554172309",
            "telephone_number": "612-725-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAZENDIN",
        "first_name": "ELIZABETH",
        "middle_name": "JOAN",
        "name_prefix": "Dr.",
        "credential": "D.O",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MN",
            "license": "49301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abejide Olufunke Fawole, CNP
• Brian Fay, PHD, ATP, RET
• Faya Therapy LLC
• Lucy Faye
• Parastoo Fazeli, MD
• Heidi Fazio, RD, LD
• Leah Fearnside, RN
• Kenisha Fearon, LMT
• Stenson Fears, ADC
• Jennifer L Fease, MSN, RN

• Physical Medicine & Rehabilitation Physician in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Physical Medicine & Rehabilitation Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.