DERIK T. WELDON (NPI# 1093924375) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093924375 |
| Entity Type | Individual |
| Full Name | DERIK T. WELDON |
| Credential | M.D. |
| Practice Address |
166 19th Street South Suite 100 Sartell MN 56377-2154 |
| Mailing Address |
Po Box 1450 Nw 6035 Minneapolis MN 55485-6035 |
| Practice Telephone | 3202510609 |
| Practice Fax Number | 3202513806 |
| Mailing Telephone | 8006344064 |
| Mailing Fax Number | 9525136880 |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2016-11-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
45308 | MN | Allopathic & Osteopathic Physicians |
| Street Address |
166 19TH STREET SOUTH SUITE 100 |
| City | SARTELL |
| State | MN |
| Zip Code | 56377-2154 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780684639 | John Gregory Dalle | Radiology | 166 19th Street South, Suite 100, Sartell, MN 56377-2154 | 2005-07-21 |
| 1598085268 | Britton Joseph Carter | Radiology | 166 19th Street South, Suite 100, Sartell, MN 56377-2154 | 2010-06-04 |
| 1457514341 | Mats Lars Liden | Radiology | 166 19th Street South, Suite 100, Sartell, MN 56377-2154 | 2008-07-09 |
| 1750544862 | Laura A Freeman | Radiology | 166 19th Street South, Sartell, MN 56377-2154 | 2008-07-08 |
| 1790879575 | Ramon R. De Guzman | Radiology | 166 19th Street South, Suite 100, Sartell, MN 56377-2154 | 2006-10-03 |
| 1740206416 | Hayley I Sheldon | Radiology | 166 19th Street South, Suite 100, Sartell, MN 56377-2154 | 2006-07-14 |
| 1235167065 | Medical Scanning Consultants Pa | Radiology | 166 19th Street South, Suite 100, Sartell, MN 56377 | 2006-06-29 |
| 1245273390 | Thomas G Cohn | Pain Medicine | 166 19th Street South, Suite 100, Sartell, MN 56377-2154 | 2006-06-14 |
| 1215977079 | Center for Pain Management, P.a. | Specialist | 166 19th Street South, Suite 101, Sartell, MN 56377 | 2006-06-08 |
| 1295788339 | Central Minnesota Center for Diagnostic Imaging LLC | Radiology | 166 19th Street South, Ste 100, Sartell, MN 56377 | 2006-05-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235783515 | Chae Norman | Massage Therapist | 303 4th Ave S, Suite C, Sartell, MN 56377 | 2019-07-25 |
| 1497317259 | Stephanie Maria Schaefer | Behavioral Analyst | 1133 Mockingbird Loop, Sartell, MN 56377 | 2019-07-02 |
| 1538722848 | Madison Toughill | Behavior Technician | 205 14th Ave E, Sartell, MN 56377 | 2019-04-22 |
| 1902388671 | Julie Ann Helms | Counselor | 101 Dehler Dr., Sartell, MN 56377 | 2018-08-30 |
| 1104337617 | Louis Chester Winskowski IIi | Orthotist | 50 14th Ave E Suite 114, Sartell, MN 56377 | 2017-10-24 |
| 1962958611 | Centracare Clinic | Exclusive Provider Organization | 166 19th Street S, Suite 202, Sartell, MN 56377 | 2016-08-31 |
| 1295197846 | Mindful Healing & Training | Counselor | 1417 15th Street South, Sartell, MN 56377 | 2016-03-23 |
| 1710342894 | Saint Cloud Hospital St. Benedict's Senior Community | Skilled Nursing Facility | 990 19th St. S., Sartell, MN 56377 | 2015-12-16 |
| 1932452661 | David Peter Pogatchnik | Pharmacist | 2251 Connecticut Ave. South, Health Partners Central Minnesota Clinics (pharmacy), Sartell, MN 56377 | 2012-10-18 |
| 1669759866 | Lakewood Health System | Clinic/Center | 161 19th St S Ste 106, Sartell, MN 56377 | 2011-11-16 |
| Find all providers in zip 56377 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356458475 | Mobile Imaging Services, LLC | Radiology | 2000 Abbott Nw Ct, Ste 115, Sartell, MN 56377 | 2006-08-24 |
| 1700831690 | Karla Gay Myhra-bloom | Radiology | 709 17th St N, Sartell, MN 56377 | 2006-05-23 |
| 1649258526 | Michael James Cumming | Radiology | 1990 Connecticut Ave S Ste 100, Sartell, MN 56377-2554 | 2006-01-03 |
| 1306846076 | Jody Allison Bolton Smith | Radiology | 1990 Connecticut Ave S, Sartell, MN 56377-2554 | 2005-07-26 |
| 1780684639 | John Gregory Dalle | Radiology | 166 19th Street South, Suite 100, Sartell, MN 56377-2154 | 2005-07-21 |
| 1023351533 | Shannon Nord | Radiology | 1990 Connecticut Ave S Ste 100, Sartell, MN 56377-2554 | 2013-04-03 |
| 1104192541 | James Dickinson | Radiology | 1990 Connecticut Ave S, Sartell, MN 56377-2554 | 2012-03-30 |
| 1487965109 | Scott Klettke | Radiology | 1990 Connecticut Ave S, Sartell, MN 56377-2554 | 2010-06-28 |
| 1598085268 | Britton Joseph Carter | Radiology | 166 19th Street South, Suite 100, Sartell, MN 56377-2154 | 2010-06-04 |
| 1487819751 | Francis X. Kigozi | Radiology | 1990 Connecticut Ave S, Sartell, MN 56377-2554 | 2008-07-25 |
| Find all providers in SARTELL | ||||
Please comment or provide details below to improve the information on DERIK T. WELDON.
| 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.