National Provider Identifier Database

FAIRMONT ORTHOPEDICS SPORTS MEDICINE PA
Specialist

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.


Contact Information

FAIRMONT ORTHOPEDICS & SPORTS MEDICINE, PA
717 S STATE ST
SUITE 900
FAIRMONT, MN56031-4469
Phone: 507-238-4949
Fax: 507-238-3377
Website:
Specialty Taxonomy Code
* Specialist 174400000X
Licensed Practical Nurse 164W00000X
Podiatric 261QP1100X
VA 261QV0200X

* Indicates primary specialty

NPI Profile & details for FAIRMONT ORTHOPEDICS & SPORTS MEDICINE, PA

NPI Number 1134173644
Legal business name
LBN
FAIRMONT ORTHOPEDICS & SPORTS MEDICINE, PA
Authorized official LINDA THOMPSON - (REVENUE CYCLE MANAGER ADMIN AP)
Entity Organization
Organization subpart No
Enumeration date 05/20/2006
Last updated 03/26/2025 - More than a year ago
Sole proprietor1 Not specified
Identifiers
  • MN Medicaid: 590024700
  • Other: 29394 HEALTHPARTNERS
  • Other: 09809248 MEDICA
  • Other: 974311025203 PREF ONE
  • Other: CB1729 RAILROAD MEDICARE
  • Other: 27084 SANFORD HEALTH
  • Other: 112399 UCARE
  • Other: 138808700 US DEPT OF LABOR
  • MN Other: 396G2PR BLUE CROSS BLUE SHIELD
  • MN Other: 40645WE BLUE CROSS BLUE SHIELD
  • MN Other: 29D51FA BLUE CROSS BLUE SHIELD CHIROPRACTIC

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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