DR. BRENNAN J BOETTCHER (NPI# 1124468962) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124468962 |
| Entity Type | Individual |
| Full Name | DR. BRENNAN J BOETTCHER |
| Credential | D.O. |
| Practice Address |
2620 Eagan Woods Dr Ste 100 Eagan MN 55121 |
| Mailing Address |
2620 Eagan Woods Dr Ste 100 Eagan MN 55121-1138 |
| Practice Telephone | 6519685201 |
| Mailing Telephone | 6519685201 |
| Enumeration Date | 2013-06-25 |
| Last Update Date | 2018-07-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208100000X | Physical Medicine & Rehabilitation | 58301 | MN | Allopathic & Osteopathic Physicians |
| Y | 2081S0010X |
Physical Medicine & Rehabilitation Specialization: Sports Medicine |
58301 | MN | Allopathic & Osteopathic Physicians |
| Street Address |
2620 EAGAN WOODS DR STE 100 |
| City | EAGAN |
| State | MN |
| Zip Code | 55121 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902875818 | Bryan C Sternberg | Physician Assistant | 2620 Eagan Woods Dr Ste 100, Eagan, MN 55121-1138 | 2006-03-14 |
| 1205254364 | Matthew Stephen Nies | Orthopaedic Surgery | 2620 Eagan Woods Dr Ste 100, Eagan, MN 55121-1138 | 2014-04-04 |
| 1447682679 | Kathryn L Roggow | Physician Assistant | 2620 Eagan Woods Dr Ste 100, Eagan, MN 55121-1138 | 2013-07-30 |
| 1922341932 | John Patrick Delaney | Orthopaedic Surgery | 2620 Eagan Woods Dr Ste 100, Eagan, MN 55121-1138 | 2013-03-28 |
| 1881972016 | Blake W Hildahl | Orthopaedic Surgery | 2620 Eagan Woods Dr Ste 100, Eagan, MN 55121-1138 | 2011-07-21 |
| 1629304654 | Thirath Mark Luong | Physician Assistant | 2620 Eagan Woods Dr Ste 100, Eagan, MN 55121-1138 | 2009-10-27 |
| 1457582793 | Matthew R Wolden | Physician Assistant | 2620 Eagan Woods Dr Ste 100, Eagan, MN 55121-1138 | 2009-08-04 |
| 1225216542 | Summit Orthopedics, Ltd. | Occupational Therapist | 2620 Eagan Woods Dr Ste 100, Eagan, MN 55121-1138 | 2008-02-08 |
| 1578515854 | Erik Scott Stroemer | Orthopaedic Surgery | 2620 Eagan Woods Dr Ste 100, Eagan, MN 55121-1138 | 2006-05-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205443850 | Birchwood Dental, LLC | Dentist | 3356 Sherman Crt Ste 101, Eagan, MN 55121 | 2020-09-28 |
| 1811552813 | Clare Muyskens | Physical Therapist | 3305 Central Park Commons Dr, Eagan, MN 55121 | 2019-05-06 |
| 1154986479 | Elp Right Living Health LLC | Assisted Living Facility | 3035 Eagandale Pl #101, Eagan, MN 55121 | 2019-05-02 |
| 1467908699 | Hy Vee Inc | Pharmacy | 1500 Central Park Commons Drive, Eagan, MN 55121 | 2016-08-28 |
| 1962861005 | Lakeline Transportation LLC | Non-emergency Medical Transport (VAN) | 1416 Shoreline Dr, Eagan, MN 55121 | 2016-02-17 |
| 1467838615 | John Berchem | Physical Therapist | 1284 Coporate Center Drive, #500, Eagan, MN 55121 | 2015-08-10 |
| 1730426099 | Carole P Cohen | Occupational Therapist | 880 Blue Gentian Road, Ste # 190, Eagan, MN 55121 | 2013-01-07 |
| 1407102882 | Emergency Physicians Professional Association | Clinic/Center | 3010 Denmark Avenue, Eagan, MN 55121 | 2012-08-03 |
| 1851692289 | Eagan Family Chiropractic & Massage | Chiropractor | 1260 Yankee Doodle Road, Suite 100, Eagan, MN 55121 | 2010-11-17 |
| 1780805218 | Bridget Marie Mcconnell | Social Worker | 680 O'neill Drive, Eagan, MN 55121 | 2007-05-01 |
| Find all providers in zip 55121 | ||||
| Taxonomy Code | 2081S0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Physical Medicine & Rehabilitation |
| Specialization | Sports Medicine |
| A physician who specializes in Sports Medicine is responsible for continuous care related to the enhancement of health and fitness as well as the prevention of injury and illness. The specialist possesses knowledge and experience in the promotion of wellness and the prevention of injury from many areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation and injuries. It is the goal of a Sports Medicine specialist to improve the healthcare of the individual engaged in physical exercise. |
| Notes: Source: American Board of Medical Specialties, 2009. www.abms.org [7/1/2009: definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154935435 | Kelly Nicole Ricke | Physical Medicine & Rehabilitation | 1 Civic Center Plaza, Hockey Office Complex, Mankato, MN 56001 | 2020-09-03 |
| 1902310154 | Dorothy Jane Hanna | Physical Medicine & Rehabilitation | 10939 Quebec Ave N, Champlin, MN 55316-3261 | 2017-11-27 |
| 1932502267 | Kyle Braulick | Physical Medicine & Rehabilitation | 5025 Edinburgh Way, Big Lake, MN 55309-8271 | 2014-10-01 |
| 1790020949 | Shelby N Kenison | Physical Medicine & Rehabilitation | 28675 740th Ave, Clarks Grove, MN 56016-4041 | 2012-11-29 |
| 1770806374 | Kevin Neil Johnson | Physical Medicine & Rehabilitation | 9913 214th St W Ste B, Lakeville, MN 55044-1914 | 2010-03-10 |
| 1962069864 | Allyson Carol Maynard | Physical Medicine & Rehabilitation | 800 Prairie Center Dr Ste 230, Eden Prairie, MN 55344-7308 | 2019-05-26 |
| 1831672492 | Nathaniel Erik Thomsen | Physical Medicine & Rehabilitation | 300 S Bruce St, Marshall, MN 56258-1934 | 2018-09-10 |
| 1023517364 | Hannah Rhiannon Salisbury | Physical Medicine & Rehabilitation | 3900 Bethel Dr, Arden Hills, MN 55112-6902 | 2018-02-01 |
| 1386006682 | Allison Nicole Schroeder | Physical Medicine & Rehabilitation | 200 1st St Sw, Rochester, MN 55905-0001 | 2016-03-25 |
| 1235530890 | Wade Johnson | Physical Medicine & Rehabilitation | 1025 Marsh St, Mankato, MN 56001-4752 | 2014-09-14 |
| Find all providers with the same taxonomy | ||||
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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.