Active NPI
Three Sixty Health Inc
Doing business as 360 Health Inc
- Psychiatry Physician
- Edina, MN
National Provider Identifier
1942066568
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- Legal business name
- THREE SIXTY HEALTH INC
- Doing business as
- 360 Health Inc
- Practice address
- 6565 France Ave S Ste 350
Edina, MN 55435-2159 - Phone
- (952) 999-4049
- NPI assigned
- Feb 21, 2024
- Last updated
- Feb 20, 2025
- 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
- Derek James Dagendesh
- Title
- Authorized Offical
- Phone
- (651) 263-1394
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | Primary |
Addresses
Primary practice location
6565 France Ave S Ste 350
Edina, MN 55435-2159
Mailing address
6565 France Ave S Ste 350
Edina, MN 55435-2159
Phone (952) 999-4049
Other names 1
- 360 HEALTH INC
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 1
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Psychiatry Physician
- Edina, MN
- NPI 1972738599
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1708473600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1740009600000",
"number": "1942066568",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6565 FRANCE AVE S STE 350",
"city": "EDINA",
"state": "MN",
"postal_code": "554352159",
"telephone_number": "952-999-4049"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6565 FRANCE AVE S STE 350",
"city": "EDINA",
"state": "MN",
"postal_code": "554352159",
"telephone_number": "952-999-4049"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "THREE SIXTY HEALTH INC",
"organizational_subpart": "NO",
"enumeration_date": "2024-02-21",
"last_updated": "2025-02-20",
"certification_date": "2025-02-20",
"status": "A",
"authorized_official_last_name": "DAGENDESH",
"authorized_official_first_name": "DEREK",
"authorized_official_middle_name": "JAMES",
"authorized_official_title_or_position": "AUTHORIZED OFFICAL",
"authorized_official_telephone_number": "651-263-1394"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "360 HEALTH INC",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "360 HEALTH INC",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Edina, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.