DR. ALLAN PHILLIP INGENITO (NPI# 1124068770) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124068770 |
| Entity Type | Individual |
| Full Name | DR. ALLAN PHILLIP INGENITO |
| Credential | M.D. |
| Practice Address |
3833 Coon Rapids Blvd Nw Suite 100 Coon Rapids MN 55433-2697 |
| Practice Telephone | 7634278320 |
| Practice Fax Number | 7633024338 |
| Mailing Telephone | 7634278320 |
| Mailing Fax Number | 7633024338 |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2019-03-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
29584 | MN | Allopathic & Osteopathic Physicians |
| N | 2084N0402X |
Psychiatry & Neurology Specialization: Neurology with Special Qualifications in Child Neurology |
29584 | MN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | HEALTHPARTNERS | HP13588 | 01 |
| MN | PREFERRED ONE | 0265011 | 01 |
| MN | MEDICA | 0509674 | 01 |
| MN | BCBS OF MN | 07691IN | 01 |
| MN | RAILROAD MEDICARE | 130005768 | 01 |
| WI | WI MEDICAID | 30709400 | 01 |
| MN | 162078900 | 05 | |
| MN | AMERICA'S PPO | 22676 | 01 |
| MN | UCARE | 100289C029 | 01 |
| Street Address |
3833 COON RAPIDS BLVD NW SUITE 100 |
| City | COON RAPIDS |
| State | MN |
| Zip Code | 55433-2697 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578529889 | Christine Kelley | Physician Assistant | 3833 Coon Rapids Blvd Nw, Suite 100, Coon Rapids, MN 55433-2643 | 2006-04-25 |
| 1700319977 | Kelly Jo Mcmartin | Counselor | 3833 Coon Rapids Blvd Nw, Suite 120, Coon Rapids, MN 55433-2643 | 2017-04-05 |
| 1114465135 | Sarah Karyn Myer | Nurse Practitioner | 3833 Coon Rapids Blvd Nw, Suite 120, Coon Rapids, MN 55433-2643 | 2017-02-09 |
| 1750823753 | Mary A Reynolds | Counselor | 3833 Coon Rapids Blvd Nw, Suite 120, Coon Rapids, MN 55433-2643 | 2016-11-08 |
| 1366994527 | Tanya Marie Svenddal | Counselor | 3833 Coon Rapids Blvd Nw, Suite 120, Coon Rapids, MN 55433-2643 | 2016-11-03 |
| 1710330691 | Tyler Zillmer | Counselor | 3833 Coon Rapids Blvd Nw, Coon Rapids, MN 55433-2643 | 2016-07-15 |
| 1568818557 | Stephanie Fish | Marriage & Family Therapist | 3833 Coon Rapids Blvd Nw, Suite 120, Coon Rapids, MN 55433-2643 | 2016-05-09 |
| 1396102364 | Alice I Congdon | Counselor | 3833 Coon Rapids Blvd Nw, Suite 120, Coon Rapids, MN 55433-2643 | 2016-01-21 |
| 1780017442 | Generations Foot and Ankle Clinic | Podiatrist | 3833 Coon Rapids Blvd Nw, Coon Rapids, MN 55433-2643 | 2013-08-16 |
| 1134406200 | Christine Zwicky | Physician Assistant | 3833 Coon Rapids Blvd Nw, Coon Rapids, MN 55433-2643 | 2011-11-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770134793 | Shelley Karee Peterson | Technician | 10311 Bittersweet St Nw, Coon Rapids, MN 55433 | 2019-09-20 |
| 1578122057 | Courtney Gau | Behavior Technician | Fraser Coon Rapids, 9120 Springbrook Dr. Nw, Coon Rapids, MN 55433 | 2019-06-10 |
| 1992275606 | Maliki Fofee Kamara | Licensed Practical Nurse | 2451 109th Ave Nw Apt. 1, Coon Rapids, MN 55433 | 2018-11-26 |
| 1992284541 | Sarah Vennes | Massage Therapist | 6400 Flying Cloud Dr, Suite 240, Eden Prairie, MN 55433 | 2018-08-13 |
| 1538646609 | Paige Prince | Behavior Technician | Fraser Coon Rapids, 9120 Springbrook Drive Nw, Coon Rapids, MN 55433 | 2018-07-23 |
| 1154828242 | Karin Lea Englund | Dentist | 9145 Springbrook Dr Nw Ste 100, Coon Rapids, MN 55433 | 2018-04-06 |
| 1235642513 | Vista Family Eye Care LLC | Optometrist | 9920 Foley Blvd Nw Ste 120, Coon Rapids, MN 55433 | 2017-11-09 |
| 1538697818 | Mohammed Nmn Ahmed | Internal Medicine | 9055 Spring Brook Drive, Allina Coon Rapids Clinic 9055, Coon Rapids, MN 55433 | 2017-05-31 |
| 1639531353 | Journi LLC | Nurse Practitioner | 277 Coon Rapids Blvd Suite 308, Coon Rapids, MN 55433 | 2016-03-22 |
| 1821457722 | Honorine Boyce | Licensed Practical Nurse | 2743 111th Ave. Nw, Coon Rapids, MN 55433 | 2016-02-19 |
| Find all providers in zip 55433 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225309875 | Jaehoon Cho | Psychiatry & Neurology | 3833 Coon Rapids Blvd Nw Ste 100, Coon Rapids, MN 55433-2697 | 2012-01-12 |
| 1538325345 | Lyla Veen | Psychiatry & Neurology | 3833 Coon Rapids Blvd Nw, Suite 100, Coon Rapids, MN 55433-2697 | 2008-07-31 |
| 1316109697 | Sailaja Enduri | Psychiatry & Neurology | 3833 Coon Rapids Blvd Nw Ste 100, Coon Rapids, MN 55433-2697 | 2008-06-27 |
| 1225216096 | Dustin Brook Harker | Psychiatry & Neurology | 3833 Coon Rapids Blvd Nw, Suite 100, Coon Rapids, MN 55433-2643 | 2008-02-04 |
| 1437276573 | Elias Bazakos | Psychiatry & Neurology | 3833 Coon Rapids Blvd Nw, Suite 100, Coon Rapids, MN 55433-2697 | 2007-03-23 |
| 1821025461 | David Logan Webster | Psychiatry & Neurology | 3833 Coon Rapids Blvd Nw, Suite 100, Coon Rapids, MN 55433-2577 | 2006-06-27 |
| 1619918448 | Daniel Craig Randa | Psychiatry & Neurology | 3833 Coon Rapids Blvd Nw, Suite 100, Coon Rapids, MN 55433-2697 | 2006-06-10 |
| 1649211186 | Thomas Leslie Murphy | Psychiatry & Neurology | 3833 Coon Rapids Blvd Nw, Suite 100, Coon Rapids, MN 55433-2697 | 2006-06-08 |
| 1275574717 | Moeen Ahmad Masood | Psychiatry & Neurology | 3833 Coon Rapids Blvd Nw, Suite 100, Coon Rapids, MN 55433-2697 | 2006-06-08 |
| 1528012051 | Masood Raheem Ghazali | Psychiatry & Neurology | 3833 Coon Rapids Blvd Nw, Suite 100, Coon Rapids, MN 55433-2697 | 2006-05-20 |
| Find all providers in COON RAPIDS | ||||
| City | COON RAPIDS |
| Zip Code | 55433 |
Please comment or provide details below to improve the information on DR. ALLAN PHILLIP INGENITO.
| 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.