DR. ALLAN JAMES LUISTRO (NPI# 1073648259) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073648259 |
| Entity Type | Individual |
| Full Name | DR. ALLAN JAMES LUISTRO |
| Credential | M.D. |
| Practice Address |
1104 7th Ave S. Box 92 Msum Hendrix Clinic & Counseling Center Moorhead MN 56563 |
| Mailing Address |
5027 Rose Creek Pkwy S Fargo ND 58104-6848 |
| Practice Telephone | 2184772211 |
| Practice Fax Number | 2184775867 |
| Mailing Telephone | 7012989024 |
| Mailing Fax Number | 7012970132 |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2012-02-22 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 37656 | MN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 804733200 | 05 | |
| ND | 17256 | 05 |
| Street Address |
1104 7TH AVE S. BOX 92 MSUM HENDRIX CLINIC & COUNSELING CENTER |
| City | MOORHEAD |
| State | MN |
| Zip Code | 56563 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346658549 | Charles Meek | Specialist/Technologist | Minnesota State University Moorhead, Nemzek Hall Room 125, Moorhead, MN 56563 | 2014-07-31 |
| 1356378848 | Keith Allen Wiedrich | Specialist/Technologist | 1107 7th St. S., Msu Moorhead - Athletics, Moorhead, MN 56563 | 2006-06-28 |
| 1235103284 | Ronda K Peterson | Specialist/Technologist | 125 Nemzek, Msum, Moorhead, MN 56563 | 2006-02-15 |
| 1124092176 | Andrea Lynn Scott | Specialist/Technologist | Nemzek 125, Minnesota State University Moorhead, Moorhead, MN 56563 | 2006-02-15 |
| 1891906202 | Joni K Mehrhoff | Speech-Language Pathologist | 1104 7th Ave South, Moorhead, MN 56563 | 2007-05-25 |
| 1982162434 | Family Health Care Center | Clinic/Center | 1104 7th Ave S # 92, Moorhead, MN 56563-0001 | 2019-03-04 |
| 1659688034 | Maribeth Kay Plankers | Speech-Language Pathologist | 1104 7th Avenue South, Msum, Moorhead, MN 56563-0001 | 2010-09-08 |
| 1700119351 | Elaine K. Pyle | Speech-Language Pathologist | 1104 7th Ave. South, Msum Box 119, Moorhead, MN 56563-0001 | 2009-09-15 |
| 1073605697 | Bruce R Hanson | Speech-Language Pathologist | 1104 7th Ave South, Msum Box 119, Moorhead, MN 56563-0001 | 2006-09-29 |
| 1457325763 | Christopher Jason Huot | Specialist/Technologist | 1104 7th Ave S, 106 C Nemzek Hall, Moorhead, MN 56563-0001 | 2006-02-14 |
| Find all providers in zip 56563 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| 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. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477039204 | Dollar Clinic Pllc | Family Medicine | 1002 1st Ave N, Moorhead, MN 56560-2003 | 2018-07-16 |
| 1609855873 | Amie C Haugo | Family Medicine | 1301 8th St S, Moorhead, MN 56560-3604 | 2006-01-16 |
| 1841299047 | Rodney John Lee | Family Medicine | 9 70th Ave Nw, Moorhead, MN 56560-6360 | 2005-07-19 |
| 1164972410 | Innovis Health LLC | Family Medicine | 720 Main Ave, Moorhead, MN 56560-2752 | 2016-10-11 |
| 1396197018 | Hope E. Meyer | Family Medicine | 801 Belsly Boulevard, Moorhead, MN 56560 | 2016-07-06 |
| 1659617504 | Innovis Health LLC | Family Medicine | 801 Belsly Blvd, Moorhead, MN 56560-5055 | 2012-12-21 |
| 1609156934 | Sanford Medical Center Fargo | Family Medicine | 1301 8th St S, Moorhead, MN 56560-3604 | 2011-08-18 |
| 1285926360 | Taylor Grant Mertz | Family Medicine | 801 Belsly Blvd, Moorhead, MN 56560-5055 | 2011-05-09 |
| 1558550442 | Rapidcare Urgent Care Pllc | Family Medicine | 720 Main Ave, Moorhead, MN 56560-2752 | 2007-10-17 |
| 1013935758 | Robert D Campbell | Family Medicine | 1301 8th St S, Moorhead, MN 56560-3604 | 2006-07-18 |
| Find all providers in MOORHEAD | ||||
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| 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.