SAMUEL W CRISWELL (NPI# 1114018223) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114018223 |
| Entity Type | Individual |
| Full Name | SAMUEL W CRISWELL |
| Credential | DPM |
| Practice Address |
1000 S Columbia Rd Grand Forks ND 58201-4032 |
| Mailing Address |
Po Box 6002 Grand Forks ND 58206-6002 |
| Practice Telephone | 7017806000 |
| Mailing Telephone | 7017805000 |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2007-10-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | 28 | ND | Podiatric Medicine & Surgery Service Providers |
| Street Address |
1000 S COLUMBIA RD |
| City | GRAND FORKS |
| State | ND |
| Zip Code | 58201-4032 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285636423 | Kirsten D Peterson | Internal Medicine | 1000 S Columbia Rd, Grand Forks, ND 58201-4032 | 2005-06-01 |
| 1942733852 | Melissa Vanwynsberghe | Occupational Therapist | 1000 S Columbia Rd, Grand Forks, ND 58201-4032 | 2017-04-07 |
| 1154862985 | Kevin Viken | Physical Therapist | 1000 S Columbia Rd, Grand Forks, ND 58201-4032 | 2017-03-13 |
| 1023567377 | Morgan Barry | Physical Therapy Assistant | 1000 S Columbia Rd, Grand Forks, ND 58201-4032 | 2016-09-28 |
| 1619423423 | Danielle Weinreis | Physical Therapy Assistant | 1000 S Columbia Rd, Grand Forks, ND 58201-4032 | 2016-08-31 |
| 1588022743 | Renae Elizabeth Johnson | Nurse Anesthetist, Certified Registered | 1000 S Columbia Rd, Grand Forks, ND 58201-4032 | 2016-02-03 |
| 1891161071 | Amaka Onyeka | Nurse Practitioner | 1000 S Columbia Rd, Grand Forks, ND 58201-4032 | 2015-08-11 |
| 1366837221 | Merri Vacura | Occupational Therapist | 1000 S Columbia Rd, Grand Forks, ND 58201-4032 | 2015-03-30 |
| 1750770319 | Marie Reuter | Speech-Language Pathologist | 1000 S Columbia Rd, Grand Forks, ND 58201-4032 | 2015-01-20 |
| 1841698933 | Kari Renfrow | Pharmacist | 1000 S Columbia Rd, Grand Forks, ND 58201-4032 | 2014-12-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255965398 | Development Homes Inc | Intermediate Care Facility, Mentally Retarded | 5509 Cottonwood Street, Grand Forks, ND 58201 | 2020-02-27 |
| 1932753779 | Lydia Pansegrau | Occupational Therapist | 2950 36th Ave S, Apt A-11, Grand Forks, ND 58201 | 2019-07-30 |
| 1407416019 | Kristina Aikens | Optometrist | 1820 S 42nd St, Grand Forks, ND 58201 | 2019-06-17 |
| 1861963209 | Jessica Kovsky | Occupational Therapist | 1375 S Columbia Rd- Altru Performance Center, Grand Forks, ND 58201 | 2018-12-11 |
| 1609345834 | Altru Specialty Services, Inc | Durable Medical Equipment & Medical Supplies | 1375 South Columbia Road, Suite A, Grand Forks, ND 58201 | 2018-11-16 |
| 1225523004 | Alicia Mae Mack | Registered Nurse | 212 S. 4th St. Suite 301, Spectra Health, Grand Forks, ND 58201 | 2018-06-25 |
| 1396260808 | Amber White | Behavior Technician | 2016 S Washington St., Grand Forks, ND 58201 | 2017-08-04 |
| 1225579840 | Kathleen Suzanne Tillman | Psychologist | 2100 S Columbia Road, Suite 202, Family Institute, PC, Grand Forks, ND 58201 | 2017-03-15 |
| 1881148906 | Melissa Pytlik Monson | Physician Assistant | 1380 S Columbia Rd - Altru Family Medcine Center, Grand Forks, ND 58201 | 2016-08-05 |
| 1477936029 | Laura Jane Carlson | Nurse Practitioner | 3165 Demers Avenue - Truyu Aesthetic Center, Grand Forks, ND 58201 | 2015-07-01 |
| Find all providers in zip 58201 | ||||
| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689761785 | Shoua Lo | Podiatrist | 4440 S Washington St - Altru Professional Center, Grand Forks, ND 58201 | 2006-10-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902933401 | Richard Gary Mason | Podiatrist | 3883 74th St. N.e., 3883 74th St. N.e., Fort Totten, ND 58335-0309 | 2007-02-28 |
| 1942341086 | Nathan Richard Randall | Podiatrist | 1 Main Hospital Road, Box 160, Belcourt, ND 58316-0160 | 2007-02-10 |
| 1386654424 | Jessica Anne Bentson | Podiatrist | 525 N 9th St, Bismarck, ND 58501-4510 | 2006-08-09 |
| 1336173871 | Basem Fanous | Podiatrist | Hwy 281n, Cando, ND 58324-0688 | 2006-07-10 |
| 1518965276 | Cherian Mathew | Podiatrist | 2215 Sims St, Dickinson, ND 58601-6521 | 2005-07-07 |
| 1992206528 | Elbowoods Memorial Health Center | Podiatrist | 1058 College Dr, New Town, ND 58763-9112 | 2018-02-28 |
| 1114453552 | Derek Anthony Mclister | Podiatrist | 5225 23rd Ave S, Fargo, ND 58104-7927 | 2017-05-04 |
| 1184010969 | Adam Finzen | Podiatrist | 4440 S Washington St - Altru Professional Center, Grand Froks, ND 58201-7245 | 2015-04-08 |
| 1659788164 | Kayla Marie Emter | Podiatrist | 2422 20th St Sw, Jamestown, ND 58401-6201 | 2014-07-16 |
| 1265845010 | Mark Domaas | Podiatrist | 4450 31st Ave S, Ste 102, Fargo, ND 58104-4557 | 2014-06-10 |
| Find all providers with the same taxonomy | ||||
| City | GRAND FORKS |
| Zip Code | 58201 |
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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.