OrganizationActive
Southdale Medical Partners Corporation
NPI 1043898778 · Primary Care Nurse Practitioner · Oakdale, MN
Provider details
- NPI number
- 1043898778
- Entity type
- Organization
- Primary specialty
- Primary Care Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Organization subpart
- No
- Authorized official
- Mitchell Brandt, Administrator(612) 961-4322
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
- Family Medicine Physician207Q00000X
Allopathic & Osteopathic Physicians
Profile Score
Established profile(67/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
902 Inwood Ave N Ste 902
Oakdale, MN 55128-6625
Phone: (952) 999-4049
Street-level locationGet directions
Mailing address
902 Inwood Ave N
Saint Paul, MN 55128-6625
Additional practice locations (1)
- 6565 France Ave S Ste 350Edina, MN 55435-2159Phone: (952) 999-4049Fax: (952) 999-4080
Registry dates
- Enumerated
- 2021-04-01
- Last updated
- 2023-05-03
- Certified
- 2023-01-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.