Active NPI
David A Geddes, MA
- Audiologist
- Saint Paul, MN
National Provider Identifier
1891767091
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 5411
- Practice address
- 2500 Como Ave
Saint Paul, MN 55108-1460 - Phone
- (651) 641-6200
- Fax
- (651) 641-6295
- NPI assigned
- Feb 2, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 5411 | MN | Primary |
Addresses
Primary practice location
2500 Como Ave
Saint Paul, MN 55108-1460
Mailing address
8170 33Rd Ave S
Minneapolis, MN 55425-4516
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 466365900 | Medicaid | MN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Qualified Audiologist
- Education
- Other, 1986
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
14000 Fairview Dr
Burnsville, MN 55337-5713
Phone (952) 993-8700
5320 Hyland Greens Dr
Bloomington, MN 55437-3934
Phone (952) 993-2400
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5411 | MN | MD | Audiologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Park Nicollet Clinic | Current | Accepting new patients | |
| Park Nicollet Clinic | Current | Accepting new patients | |
| Park Nicollet Clinic | Current | Accepting new patients |
Locations
5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400
Organizations & group practices 3
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.
-
- Family Medicine Physician
- St Louis Park, MN
- NPI 1780621904
-
- Family Medicine Physician
- St Louis Park, MN
- NPI 1063897593
-
- Family Medicine Physician
- Brooklyn Park, MN
- NPI 1447668678
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138838400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615939200000",
"number": "1891767091",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8170 33RD AVE S",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554254516"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2500 COMO AVE",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551081460",
"telephone_number": "651-641-6200",
"fax_number": "651-641-6295"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GEDDES",
"first_name": "DAVID",
"middle_name": "A",
"credential": "MA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-02",
"last_updated": "2021-03-17",
"certification_date": "2021-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "MN",
"license": "5411",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "466365900",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Saint Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.