Active NPI
Mia Marie Vidmar, MCM, L.AC, DIPL.AC
- Acupuncturist
- Eden Prairie, MN
National Provider Identifier
1932665965
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 1902
- Practice address
- 800 Prairie Center Dr Ste 210
Eden Prairie, MN 55344-7328 - Phone
- (952) 234-9210
- Fax
- (952) 204-3933
- NPI assigned
- Feb 14, 2019
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 1902 | MN | Primary |
Addresses
Primary practice location
800 Prairie Center Dr Ste 210
Eden Prairie, MN 55344-7328
Mailing address
800 Prairie Center Dr Ste 210
Eden Prairie, MN 55344-7328
Phone (952) 234-9210
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1902 | MN | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eden Therapy Center, LLC | Acupuncturist | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1550102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1550102400000",
"number": "1932665965",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "800 PRAIRIE CENTER DR STE 210",
"city": "EDEN PRAIRIE",
"state": "MN",
"postal_code": "553447328",
"telephone_number": "952-234-9210"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 PRAIRIE CENTER DR STE 210",
"city": "EDEN PRAIRIE",
"state": "MN",
"postal_code": "553447328",
"telephone_number": "952-234-9210",
"fax_number": "952-204-3933"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VIDMAR",
"first_name": "MIA",
"middle_name": "MARIE",
"credential": "MCM, L.AC, DIPL.AC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-02-14",
"last_updated": "2019-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "MN",
"license": "1902",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eden Prairie, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.