RIVERVIEW CLINIC (NPI# 1205263860) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205263860 |
| Entity Type | Organization |
| Organization Name | RIVERVIEW CLINIC |
| Practice Address |
105 International Dr Red Lake Falls MN 56750-4665 |
| Mailing Address |
607 3rd Ave S Grand Forks ND 58201-4513 |
| Practice Telephone | 2182534603 |
| Mailing Telephone | 7017417384 |
| Enumeration Date | 2013-09-27 |
| Last Update Date | 2013-09-27 |
| Authorized Official Name | MARY BUSS WITKUR (PHYSICIAN COORDINATOR) |
| Authorized Official Telephone | 2182819200 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
MN | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
105 INTERNATIONAL DR |
| City | RED LAKE FALLS |
| State | MN |
| Zip Code | 56750-4665 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053401984 | Thrifty Drug Stores Inc | Durable Medical Equipment & Medical Supplies | 105 International Dr, Suite 102, Red Lake Falls, MN 56750-4665 | 2006-10-13 |
| 1992187868 | Tia Michelle Gullickson | Nurse Practitioner | 105 International Dr, Ste. 126, Red Lake Falls, MN 56750-4665 | 2015-06-26 |
| 1467894337 | Richard Walter Seeger | Pharmacist | 105 International Dr, Red Lake Falls, MN 56750-4665 | 2013-07-22 |
| 1841581212 | Riverview Healthcare Association | Clinic/Center | 105 International Dr, Suite 25, Red Lake Falls, MN 56750-4665 | 2011-04-20 |
| 1942460811 | 1 Body Health and Fitness Pa | Chiropractor | 105 International Dr, Suite 121, Red Lake Falls, MN 56750-4665 | 2008-06-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073788311 | Hillcrest Senior Living | Skilled Nursing Facility | 311 Broadway Ave Ne, Red Lake Falls, MN 56750 | 2008-04-28 |
| 1295180313 | Lesmeister Dental LLC | Dentist | 105 International Drive, Suite 110, Red Lake Falls, MN 56750-0236 | 2016-04-26 |
| 1710922786 | Patrick C Alcorn | Dentist | 105 International Drive, Suite #6, Red Lake Falls, MN 56750-0236 | 2006-06-16 |
| 1578643318 | Ind School District 630 | Local Education Agency (LEA) | 404 Champagne Ave Sw, Red Lake Falls, MN 56750-0399 | 2006-10-16 |
| 1770704587 | Red Lake Falls Volunteer Ambulance Association | Ambulance | 201 Champagne Ave Sw, Red Lake Falls, MN 56750-4003 | 2007-05-01 |
| 1205064300 | Red Lake County Social Services | Case Management | 125 Edwards Ave Sw, Red Lake Falls, MN 56750-4019 | 2009-06-26 |
| 1093009532 | Jo Lambert | Social Worker | 125 Edwards Ave Sw, Red Lake Falls, MN 56750-4019 | 2011-06-01 |
| 1962515940 | Riverview Healthcare Association | Skilled Nursing Facility | 311 Broadway Ave Ne, Red Lake Falls, MN 56750-4224 | 2006-08-16 |
| 1871682344 | Altru Health System | Clinic/Center | 312 International Dr, Red Lake Falls, MN 56750-4603 | 2006-10-12 |
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255969150 | Isaac Waalen | Physician Assistant | 5420 Circle Down, Minneapolis, MN 55416-1312 | 2020-03-28 |
| 1730643701 | Christina Jones | Physician Assistant | 11850 Blackfoot St Nw Ste 270, Coon Rapids, MN 55433-2593 | 2019-01-24 |
| 1114492964 | Molly Goss | Physician Assistant | 1817 Sunset Dr, Northfield, MN 55057-3246 | 2018-10-09 |
| 1932600160 | Ellen Kathryn Freeman | Physician Assistant | 111 Hundertmark Rd Ste 480, Chaska, MN 55318-1485 | 2018-02-22 |
| 1174041875 | Kristen Webb | Physician Assistant | 3931 Louisiana Ave S, Suite E-500, St. Louis Park, MN 55426 | 2017-09-01 |
| 1073051751 | Hannah Elizabeth Rosenthal Danielson | Physician Assistant | 640 Jackson St # Ms 11102m, Saint Paul, MN 55101 | 2017-02-02 |
| 1457893984 | Daniel Ryan Nguyen | Physician Assistant | 14551 Co Rd #11 #100, Burnsville, MN 55337 | 2016-11-15 |
| 1538545686 | Kathryn Jelle | Physician Assistant | 3931 Louisiana Ave S # 55426, St Louis Park, MN 55426-5000 | 2015-07-30 |
| 1831503267 | Karrah Oliver | Physician Assistant | 205 Roosevelt Ave W, Karlstad, MN 56732-4022 | 2014-06-13 |
| 1477981777 | Melissa Ferraz De Toledo | Physician Assistant | 9145 Springbrook Dr Nw Ste 300, Coon Rapids, MN 55433-5897 | 2013-10-23 |
| Find all providers with the same taxonomy | ||||
| City | RED LAKE FALLS |
| Zip Code | 56750 |
Please comment or provide details below to improve the information on RIVERVIEW CLINIC.
| 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.