PDR SOUTHDALE, INC – Occupational Therapist, NPI 1073626008

PDR SOUTHDALE, INC is a healthcare provider. based in Minnetonka, Minnesota. specializing in Occupational Therapist. The NPI Number for PDR SOUTHDALE, INC is 1073626008

Main info

Organization
Name
PDR SOUTHDALE, INC
NPI
1073626008
Phone
Not provided
Address
11822 BREN RD
Authorized Official
DR. TODD WALLACE GINKEL PRESIDENT/OWNER D.C.
Enumeration Date
16 August 2006
Last Update Date
11 September 2025
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience53
Completeness85
Years active:19State licenses:0Digital endpointsOther names

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Provider Addresses for PDR SOUTHDALE, INC

  • 11822, Bren Road, Minnetonka, Hennepin County, Minnesota, 55343, United States

    MINNETONKA, MN 553439464

    Phone:

    Type: Mailing

  • 3400, West 66th Street, Southdale, Edina, Hennepin County, Minnesota, 55435, United States

    SUITE 450

    EDINA, MN 554352111

    Phone: (952) 908-2700

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

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Medicare Enrollment & Revalidation

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Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55343)

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Reviews

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Frequently asked questions

What unique ID ties claims to PDR SOUTHDALE, INC?
NPI 1073626008 is assigned to PDR SOUTHDALE, INC under the national enumeration system.
Is PDR SOUTHDALE, INC active in the national directory?
PDR SOUTHDALE, INC's public NPI profile is in an active state.
What kind of provider is PDR SOUTHDALE, INC?
The page reflects Occupational Therapist for PDR SOUTHDALE, INC. Clinical services aligned with this taxonomy classification.
Where is PDR SOUTHDALE, INC's primary listing?
We display Minnetonka, Minnesota because that is what the record indicates for PDR SOUTHDALE, INC.
Is PDR SOUTHDALE, INC a real provider?
This page reflects official NPPES data for NPI 1073626008. Always confirm identity and privileges with the practice and licensing boards.

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