GRAYSON W BLOMBERG


Address: 15700 37th Ave N Ste 150, Plymouth, MN 55446-3675
Phone: 6519685201

GRAYSON W BLOMBERG (NPI# 1003057118) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1003057118
Entity Type Individual
Full Name GRAYSON W BLOMBERG
Credential PA-C
Practice Address 15700 37th Ave N Ste 150
Plymouth
MN 55446-3675
Mailing Address 710 Commerce Dr Ste 200
Woodbury
MN 55125-4925
Practice Telephone 6519685201
Mailing Telephone (651) 968-5201
Enumeration Date 2009-03-19
Last Update Date 2017-08-16
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AS0400X Physician Assistant
Specialization: Surgical Technologist
10560 MN Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 15700 37TH AVE N STE 150
City PLYMOUTH
State MN
Zip Code 55446-3675

Providers in the same location

NPI Name Taxonomy Address Enumeration
1063414845 David W Spight Physical Medicine & Rehabilitation 15700 37th Ave N Ste 150, Plymouth, MN 55446-3675 2005-08-11
1992330401 Chelsie Rachelle Richards Physician Assistant 15700 37th Ave N Ste 150, Plymouth, MN 55446-3675 2020-03-04
1548821622 Ryan Heisler Nurse Practitioner 15700 37th Ave N Ste 150, Plymouth, MN 55446-3675 2019-06-27
1932626025 Cynthia C Konrath Physician Assistant 15700 37th Ave N Ste 150, Plymouth, MN 55446-3675 2017-08-29
1295288660 Ashley Renee Aydt Physician Assistant 15700 37th Ave N Ste 150, Plymouth, MN 55446 2016-08-02
1447600283 Brendan Murphy Physician Assistant 15700 37th Ave N Ste 150, Plymouth, MN 55446-3675 2016-06-13
1053779215 Summit Orthopedics, Ltd Physician Assistant 15700 37th Ave N Ste 150, Plymouth, MN 55446-3675 2016-02-03
1386012466 Britta K Rosenow Nurse Practitioner 15700 37th Ave N Ste 150, Plymouth, MN 55446-3675 2015-09-08
1548650278 Johnathan R Furzland Nurse Practitioner 15700 37th Ave N Ste 150, Plymouth, MN 55446-3675 2015-02-03
1225437965 Allison K Buth Nurse Practitioner 15700 37th Ave N Ste 150, Plymouth, MN 55446-3675 2014-08-19
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1114552379 Molly M Mahoney Pharmacist 4110 Juneau Lane N, Plymouth, MN 55446 2020-03-09
1073064804 Owen Payne Kusick Student in an Organized Health Care Education/Training Program 16717 49th Pl N, Plymouth, MN 55446 2016-10-17
1043696214 Kari Shoemaker Speech-Language Pathologist 5855 Cheshire Parkway, Plymouth, MN 55446 2015-08-10
1902206899 Kathleen E Steensma Nurse Practitioner 15700 37th Ave N. #110, Plymouth, MN 55446 2014-08-27
1851715163 Group Health Plan Inc Clinic/Center 5000 Fernbrook Ln N, Plymouth, MN 55446 2014-02-06
1588903009 Laura Davidson Physician Assistant 3365 Plymouth Blvd., Suite 110, Plymouth, MN 55446 2013-02-04
1366680688 Walgreen Co Durable Medical Equipment & Medical Supplies 6025 Shenandoah Ln N, Plymouth, MN 55446 2009-01-23
1205046646 Merida A Miller Obstetrics & Gynecology 4155 Cty Rd 101 N, Plymouth, MN 55446 2007-05-23
1376684746 West Metro Ophthalmology, Pa Ophthalmology 15655 37th Ave N Ste 200, Plymouth, MN 55446 2007-02-09
1952401390 Grand St Paul Cvs LLC Pharmacy 4140 Rd 101 N, Plymouth, MN 55446 2006-09-25
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Taxonomy Information

Taxonomy Code 363AS0400X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Surgical Technologist

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1225532385 Folsom Physicain Assistant First Assist, Inc Physician Assistant Nina Vasiliev Pa-c, 15407 Muller Rd, Plymouth, CA 95669-9770 2018-03-22
1528544772 Michaela Jean Butler Physician Assistant 275 Sandwich St, Plymouth, MA 02360-2183 2018-07-11
1700385218 Christina Marie Jensen Physician Assistant 15700 37th Ave N Ste 210, Plymouth, MN 55446-3662 2018-02-09
1932626025 Cynthia C Konrath Physician Assistant 15700 37th Ave N Ste 150, Plymouth, MN 55446-3675 2017-08-29
1447600283 Brendan Murphy Physician Assistant 15700 37th Ave N Ste 150, Plymouth, MN 55446-3675 2016-06-13
1760776793 Catherine K Robinson Physician Assistant 15700 37th Ave N Ste 150, Plymouth, MN 55446-3675 2011-06-07

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1194120204 Nathan C Clapper Physician Assistant 3580 Arcade St Ste 100, Vadnais Heights, MN 55127-7135 2014-10-31
1003180555 Elizabeth K Saterenzoller Physician Assistant 1015 Marsh Street, Mankato, MN 56002-8673 2012-03-01
1477824472 Andrea Jo Pitzl Physician Assistant 3208 36th Ave Ne, St Anthony, MN 55418-1713 2012-01-23
1447560693 Jeanine Marie Edstrom Physician Assistant 1185 Town Centre Dr Ste 200, Eagan, MN 55123-1343 2010-10-20
1841504792 Michelle R Aumock Physician Assistant 8100 W 78th Street, Ste 230, Edina, MN 55439 2010-08-03
1194042390 Gerald Frederick Anderson Physician Assistant 4060 Haines Rd, #104, Duluth, MN 55811-1746 2010-04-27
1558683904 Oswaldo Serge Physician Assistant 4036 3rd St Nw, Rochester, MN 55901-7564 2010-02-25
1417288945 Amanda Kay Johnson Physician Assistant 201 W Center St Ei-01 Surgical Assistant, Rochester, MN 55902-3003 2010-01-22
1790922755 Jenelle Cecilia Rock Physician Assistant 1950 Northwestern Ave S, Suite 102, Stillwater, MN 55082-7590 2009-01-13
1174775514 Nathan J Nistler Physician Assistant 3580 Arcade Stq, Vadnais Heights, MN 55127-7135 2008-10-16
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Competitor

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City PLYMOUTH
Zip Code 55446

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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