DR. GARY EDWIN GUNDERSON (NPI# 1093835159) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1093835159 |
Entity Type | Individual |
Full Name | DR. GARY EDWIN GUNDERSON |
Credential | ED. D, MS LP |
Practice Address |
702 Sw 5th St Brainerd MN 56401-3997 |
Mailing Address |
28022 County Road 107 Pequot Lakes MN 56472-3312 |
Practice Telephone | 2184546369 |
Mailing Telephone | 2188382448 |
Enumeration Date | 2007-03-30 |
Last Update Date | 2007-07-08 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 103TC1900X |
Psychologist Specialization: Counseling |
LP2801 | MN | Behavioral Health & Social Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MN | PR ONE | 1012381 | 01 |
MN | HP | 25543 | 01 |
MN | UBH | 62-47591 | 01 |
MN | BHP | 150743 | 01 |
MN | BCBS | 4K588GU | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1699768135 | Gary G Gunderson | Optometrist | 3241 S Michigan Ave, Chicago, IL 60616-3849 | 2005-08-30 |
Street Address |
702 SW 5TH ST |
City | BRAINERD |
State | MN |
Zip Code | 56401-3997 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1396222832 | Nicholas James Manning | Physical Therapist | 7350 Clearwater Rd N, Baxter, MN 56401 | 2018-07-27 |
1952819757 | Hannah Marie Darabi | Physical Therapist | Essentia Health Rehabilitation Services, 2016 South Sixth Street, Brainer, MN 56401 | 2018-01-15 |
1154867406 | Nancy Ann Schauer | Social Worker | 823 Maple Street, Northern Pine Mental Health Center, Brainerd, MN 56401 | 2017-01-10 |
1336530310 | Audrey Jean Twit | Pharmacist | 523 North Third Street, Essentia Health St Joseph's Medical Center, Brainerd, MN 56401 | 2015-02-11 |
1245638584 | The Renneke Chiropractic Clinic | Physical Therapist | 623 Madison St., Brainerd, MN 56401 | 2014-12-19 |
1124420179 | Jenna Niggeler | Acupuncturist | 1001 Kingwood St Ste 119a, Brainerd, MN 56401 | 2014-09-22 |
1073933719 | Nicholas Adam Lesmeister | Orthopaedic Surgery | 2014 South 6th Street, Brainerd, MN 56401 | 2014-04-21 |
1073864666 | Jennifer L. Owens | Marriage & Family Therapist | 4706 Wilderness Ct Ste 101, Brainerd, MN 56401 | 2012-09-24 |
1619297447 | Christine Elaine Smalling | Licensed Practical Nurse | 6317 Estate Circle Drive, Brainerd, MN 56401 | 2010-06-03 |
1528241577 | Dannia Lor Vang | Pharmacist | 2024 South 6th St, Clinic Pharmacy, Brainerd, MN 56401 | 2007-12-13 |
Find all providers in zip 56401 |
Taxonomy Code | 103TC1900X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Psychologist |
Specialization | Counseling |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1083782486 | Ruth Ann Schaefer | Psychologist | 115 1st Street N, Brainerd, MN 56401 | 2006-12-01 |
1710033279 | Caroline Jane Bad Heart Bull | Psychologist | 523 N 3rd St, Brainerd, MN 56401-3054 | 2007-01-26 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1497355275 | Paul Franklin Singh | Psychologist | 150 E Travelers Trl Ste G, Burnsville, MN 55337-6890 | 2020-10-29 |
1639779127 | Abdifatah Nuuh | Psychologist | 4204 16th Ave S, Minneapolis, MN 55407-3312 | 2020-10-26 |
1134732514 | Colleen Cashen | Psychologist | 1341 Cleveland Ave S, Saint Paul, MN 55116-2653 | 2020-08-26 |
1295357440 | Pure Potential Counseling | Psychologist | 18685 Dylan Dr, Farmington, MN 55024-7070 | 2020-05-11 |
1871115337 | Melissa Jean King | Psychologist | 205 W 2nd St Ste 437, Duluth, MN 55802-1922 | 2020-05-07 |
1841811296 | Kristen Math X | Psychologist | 1603 Pebble Creek Dr, Sartell, MN 56377-4538 | 2020-04-27 |
1245859982 | Thomas Allen | Psychologist | 12 Valley View Pl, Mankato, MN 56001-2500 | 2020-04-13 |
1033749163 | Neurocalm, LLC | Psychologist | 3153 Hennepin Ave Ste 211, Minneapolis, MN 55408-2620 | 2020-01-16 |
1457999500 | Megan Robb | Psychologist | 555 W Broadway Ave Ste 2and3, Forest Lake, MN 55025-1175 | 2019-12-18 |
1821635723 | Leadership Coaching Institute LLC | Psychologist | 1264 Garden St, Ogilvie, MN 56358-3520 | 2019-12-10 |
Find all providers with the same taxonomy |
Please comment or provide details below to improve the information on DR. GARY EDWIN GUNDERSON.
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.