1. Home
  2. Directory
  3. Minnesota
  4. Minneapolis
  5. Internal Medicine
  6. NPI Profile
Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

FAIRVIEW SPECIALTY SERVICES
NPI 1174494827
Internal Medicine in Minneapolis, MN

Active since September 16, 2025CLIA Certified · 2 labs
2450 RIVERSIDE AVE, MINNEAPOLIS, MN 55454(855) 324-7843 Get Directions Write a Review

NPPES record last updated: August 21, 2026. Verified against the NPPES registry weekly; last sync: September 13, 2026.

Record update history: Aug 21, 2026, Sep 16, 2025 (2 updates tracked since 2025).

About Fairview Specialty Services NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FAIRVIEW SPECIALTY SERVICES (NPI 1174494827) is a healthcare organization registered as an internal medicine in Minneapolis, Minnesota and active in the NPI registry since September 2025. The organization holds 2 active CLIA laboratory certificates, maintains 4 additional practice locations, and lists Maureen Veronica-reger Ring, Sys Dir Govt Reimb & Netwk Rel, as its authorized official.

NPPES Registry Identity

NPI1174494827
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameFAIRVIEW SPECIALTY SERVICES
Location Address2450 RIVERSIDE AVEMinneapolis, MN 55454-1450
Mailing Address1700 University Ave WSaint Paul, MN 55104-3727
Phone(855) 324-7843
Organization SubpartNo
Authorized OfficialMaureen Veronica-reger RingSys Dir Govt Reimb & Netwk Rel · (612) 672-6740
Enumeration DateSeptember 16, 2025
Last NPPES UpdateAugust 21, 20262 updates tracked since enumeration
NPPES CertifiedAugust 21, 2026
✔ NPI 1174494827 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
2450 RIVERSIDE AVE, Minneapolis, MN 55454
Open in Google Maps ↗

Secondary Practice Locations 4

Location 11875 Woodwinds Dr Ste 130Woodbury, MN 55125-4476 · Phone (651) 232-0228
Location 21925 Woodwinds DrWoodbury, MN 55125-4445 · Phone (651) 232-0228
Location 31875 Woodwinds Dr Ste Wl30Woodbury, MN 55125-2534 · Phone (651) 232-0228
Location 41875 Woodwinds Dr Ste W150Woodbury, MN 55125-2298 · Phone (651) 232-0228

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 24D2114225

Fairview Specialty Services Woodbury Specialty Clinic · Woodbury, MN
Active · expires Jun 8, 2028
CLIA Number24D2114225
Laboratory TypePractitioner Other
Certificate Effective DateJune 9, 2026
Certificate Expiration DateJune 8, 2028
Laboratory DirectorSherif H. Tawfic
Laboratory Phone(651) 232-6802
Laboratory LocationFairview Specialty Services Woodbury Specialty Clinic1875 Woodwinds Drive, Woodbury, MN 55125
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate of Waiver 24D2130601

Fairview Specialty Services Woodbury Pediatric Clinic · Woodbury, MN
Active · expires May 11, 2027
CLIA Number24D2130601
Laboratory TypePhysician Office
Certificate Effective DateMay 12, 2025
Certificate Expiration DateMay 11, 2027
Laboratory DirectorCarol E. Johannes
Laboratory Phone(612) 365-6777
Laboratory LocationFairview Specialty Services Woodbury Pediatric Clinic9680 Tamarack Rd Suite 130, Woodbury, MN 55125
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MICHELLE IRENE GRAY
Rehabilitation Practitioner
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 672-6000
DR. KATHLEEN F SADAK MD
Pediatrics
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 273-6402
DR. ADMATHA MUTHYALA WINFRED MD
Internal Medicine (Geriatric Medicine)
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 672-6000
KELLY SCHELLER WILLIAMS
Dietitian, Registered
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 273-3216
MRS. MARY SUSAN CLIPP CPNP-AC
Nurse Practitioner (Pediatrics, Critical Care)
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 365-3100
DANIEL TESFAYE KEBED MD
Internal Medicine
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 672-6000
MS. CHELSEA ANJELICA MIELKE PA-C
Physician Assistant
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 672-6000
MRS. JESSICA LYNN MCADAM
Nurse Anesthetist, Certified Registered
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 273-8383

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Fairview Specialty Services's NPI number?

The NPI number for Fairview Specialty Services is 1174494827. It was assigned to this organization in the NPPES registry on September 16, 2025.

Where is Fairview Specialty Services located?

Fairview Specialty Services is located at 2450 Riverside Ave, Minneapolis, MN 55454. The listed phone number is (855) 324-7843.

What is Fairview Specialty Services's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Does Fairview Specialty Services hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Fairview Specialty Services was last updated on August 21, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 31 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.