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BROOKLYN PARK CLINIC - DME
NPI 1558453787
Durable Medical Equipment & Medical Supplies in Brooklyn Park, MN

Active since September 28, 2006CLIA 24D1097781 · Waiver
10000 ZANE AVE N, BROOKLYN PARK, MN 55443(763) 572-5710(763) 569-6200 Get Directions Write a Review

NPPES record last updated: November 13, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Brooklyn Park Clinic - Dme NPPES

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

BROOKLYN PARK CLINIC - DME (NPI 1558453787) is a healthcare organization registered as a durable medical equipment & medical supplies in Brooklyn Park, Minnesota and active in the NPI registry since September 2006. The organization holds a CLIA Waiver certificate valid through September 21, 2026 and lists Joen V Condon, Chief Financial Officer, as its authorized official.

NPPES Registry Identity

NPI1558453787
Entity TypeOrganization
Primary Taxonomy332B00000X
Legal Business NameCOLUMBIA PARK MEDICAL GROUP, PA
Location Address10000 ZANE AVE NBrooklyn Park, MN 55443-1400
Mailing Address6401 University Ave NeFridley, MN 55432-4341 · (763) 572-5710 · Fax (763) 571-3008
Phone(763) 572-5710
Fax(763) 569-6200
Organization SubpartYes
Authorized OfficialJoen V CondonChief Financial Officer · (763) 586-5839
Enumeration DateSeptember 28, 2006
Last NPPES UpdateNovember 13, 2007
✔ NPI 1558453787 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDurable Medical Equipment & Medical SuppliesSuppliers
Taxonomy Code332B00000X
Definition
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.
10000 ZANE AVE N, Brooklyn Park, MN 55443
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Other Names 1

Other NameBrooklyn Park Clinic - Dme

Other Identifiers 2

Other02071BRMN · Bcbs Dme Number
Medicare NSC0463570005MN

CLIA Laboratory Certificates CMS CLIA

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 of Waiver 24D1097781

Brooklyn Park · Brooklyn Park, MN
Active · expires Sep 21, 2026
CLIA Number24D1097781
Laboratory TypeCommunity Clinic
Certificate Effective DateSeptember 22, 2024
Certificate Expiration DateSeptember 21, 2026
Laboratory DirectorDr. Erin V. Grimm
Laboratory Phone(763) 236-5300
Laboratory LocationBrooklyn Park9300 Noble Pkwy, Brooklyn Park, MN 55443
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.

HILARY G WILDE RD, CDE
Dietitian, Registered
10000 ZANE AVE N
BROOKLYN PARK, MN 55443
Hennepin County (651) 357-3818
TASHEENA BROADNAX
Physician Assistant
10000 ZANE AVE N
BROOKLYN PARK, MN 55443
Hennepin County (763) 528-6999
RENE L. ROYAL O.D.
Optometrist
10000 ZANE AVE N
BROOKLYN PARK, MN 55443
Hennepin County (763) 572-5710
DR. SYDNI KAYE DAVIS FARHAT OD
Optometrist
10000 ZANE AVE N
MINNEAPOLIS, MN 55443
Hennepin County (763) 528-6999
AUDREY ANNE QUANRUD PT
Physical Therapist
10000 ZANE AVE N
BROOKLYN PARK, MN 55443
Hennepin County (763) 572-5710
DR. CHRISTOPHER MICHAEL KISSELL FNP
Nurse Practitioner (Family)
10000 ZANE AVE N
BROOKLYN PARK, MN 55443
Hennepin County (763) 528-6999
LINDSEY MAE MILES
Physical Therapist
10000 ZANE AVE N
BROOKLYN PARK, MN 55443
Hennepin County (612) 273-6228
KRISTEN ELIZABETH METCALF PA-C
Physician Assistant
10000 ZANE AVE N
BROOKLYN PARK, MN 55443
Hennepin County (763) 528-6999

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 Columbia Park Medical Group, PA's NPI number?

The NPI number for Columbia Park Medical Group, PA is 1558453787. It was assigned to this organization in the NPPES registry on September 28, 2006. The provider is also known as Brooklyn Park Clinic - Dme.

Where is Columbia Park Medical Group, PA located?

Columbia Park Medical Group, PA is located at 10000 Zane Ave N, Brooklyn Park, MN 55443. The listed phone number is (763) 572-5710.

What is Columbia Park Medical Group, PA's specialty?

The primary specialty registered for this NPI is Durable Medical Equipment & Medical Supplies with taxonomy code 332B00000X.

Does Columbia Park Medical Group, PA hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 24D1097781) is associated with this NPI, valid through September 21, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Columbia Park Medical Group, PA was last updated on November 13, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years 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.