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OLIVE & HAZEL HEALTH, PLLC
NPI 1629742903
Family Medicine in Plymouth, MN

Active since August 02, 2021CLIA 24D2190633 · Waiver
12105 29TH AVE N, PLYMOUTH, MN 55441(651) 424-2241 Get Directions Write a Review

NPPES record last updated: June 24, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jun 24, 2025, Mar 14, 2025, Oct 11, 2022 and 1 more (4 updates tracked since 2021).

About Olive & Hazel Health, Pllc NPPES

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

OLIVE & HAZEL HEALTH, PLLC (NPI 1629742903), doing business as Fourth Trimester Doc, is a healthcare organization registered as a family medicine in Plymouth, Minnesota and active in the NPI registry since August 2021. The organization holds a CLIA Waiver certificate valid through August 17, 2026 and lists Michelle Spies Haggerty, Owner/founder/physician, as its authorized official.

NPPES Registry Identity

NPI1629742903
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameOLIVE & HAZEL HEALTH, PLLC
Location Address12105 29TH AVE NPlymouth, MN 55441-2955
Mailing Address12105 29th Ave NPlymouth, MN 55441-2955 · (612) 424-2241
Phone(651) 424-2241
Organization SubpartNo
Authorized OfficialMichelle Spies HaggertyOwner/founder/physician · (612) 424-2241
Enumeration DateAugust 2, 2021
Last NPPES UpdateJune 24, 20254 updates tracked since enumeration
NPPES CertifiedJune 24, 2025
✔ NPI 1629742903 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

12105 29TH AVE N, Plymouth, MN 55441
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Other Names 1

Doing Business AsFourth Trimester Doc

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

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 24D2190633

Olive & Hazel Health, PLLC · Plymouth, MN
Active · expires Aug 17, 2026
CLIA Number24D2190633
Laboratory TypePhysician Office
Certificate Effective DateAugust 18, 2024
Certificate Expiration DateAugust 17, 2026
Laboratory DirectorMichelle S. Haggerty
Laboratory Phone(612) 424-2241
Laboratory LocationOlive & Hazel Health, PLLC12105 29th Ave N, Plymouth, MN 55441
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

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

MICHELLE SPIES HAGGERTY MD
Family Medicine
12105 29TH AVE N
PLYMOUTH, MN 55441
Hennepin County (612) 424-2241

Frequently Asked Questions

What is OLIVE & HAZEL HEALTH, PLLC's NPI number?

The NPI number assigned to this healthcare provider is 1629742903, enumerated as an "organization" on August 02, 2021.

Where is the provider located?

The provider is located at 12105 29TH AVE N PLYMOUTH, MN 55441 and the phone number is (651) 424-2241.

What is the provider's specialty?

Family Medicine with taxonomy code 207Q00000X.