RONALD BRUCE WAHLBERG (NPI# 1205891611) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205891611 |
| Entity Type | Individual |
| Full Name | RONALD BRUCE WAHLBERG |
| Credential | MD |
| Practice Address |
1313 Penn Avenue North Minneapolis MN 55411 |
| Practice Telephone | 6125432558 |
| Practice Fax Number | 6123024870 |
| Mailing Telephone | 6125432558 |
| Mailing Fax Number | 6123024870 |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2013-02-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 29429 | MN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 788785000 | 05 |
| Street Address |
1313 PENN AVENUE NORTH |
| City | MINNEAPOLIS |
| State | MN |
| Zip Code | 55411 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689638868 | Catherine L Upham | Optometrist | 1313 Penn Avenue North, Minneapolis, MN 55411 | 2006-04-14 |
| 1326306648 | April Katherine Wilhelm | Family Medicine | 1313 Penn Avenue North, Minneapolis, MN 55411 | 2012-04-24 |
| 1639137649 | Adeline C King | Pediatrics | 1313 Penn Avenue North, Minneapolis, MN 55411 | 2006-05-02 |
| 1053378141 | Deirdre Ammie Golden | Psychologist | 1313 Penn Avenue North, Minneapolis, MN 55411 | 2006-05-01 |
| 1447217849 | Janna K Carlson | Family Medicine | 1313 Penn Avenue North, Minneapolis, MN 55411 | 2006-04-28 |
| 1356308753 | Kathleen Marian Kreitzer | Nurse Practitioner | 1313 Penn Avenue North, Minneapolis, MN 55411 | 2006-04-28 |
| 1518924919 | Jennifer Louise Shimek | Dentist | 1313 Penn Avenue North, Minneapolis, MN 55411 | 2006-04-28 |
| 1750348546 | Lavonne M Moore | Nurse Practitioner | 1313 Penn Avenue North, Minneapolis, MN 55441 | 2006-04-27 |
| 1497711253 | Janet C Browde Brenner | Optometrist | 1313 Penn Avenue North, Minneapolis, MN 55411 | 2006-04-21 |
| 1306802160 | Bhaskarani Jasthi | Dietitian, Registered | 1313 Penn Avenue North, Minneapolis, MN 55411 | 2006-04-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477101483 | Minnesota Mental Health Solutions | Social Worker | 1007 W Broadway Ave Ste 200, Minneapolis, MN 55411 | 2019-09-03 |
| 1154980233 | Access Group Home LLC | Home Health | 1122 Upton Ave N, Minneapolis, MN 55411 | 2019-06-11 |
| 1780036202 | Marcia Karen Powless | Registered Nurse | 2339 River Pointe Lane, Minneapolis, MN 55411 | 2016-07-08 |
| 1104287663 | Abdikarim Abdille | Contractor | 521 Lyn Park Cir N, Minneapolis, MN 55411 | 2016-03-11 |
| 1962801399 | Olu's Center | Clinic/Center | 1315 12th Ave N, Minneapolis, MN 55411 | 2014-08-21 |
| 1689086639 | Claudia Alejandra Patino Gonzalez | Student in an Organized Health Care Education/Training Program | 1020 West Broadway Avenue, Minneapolis, MN 55411 | 2014-05-27 |
| 1306283445 | Advanced Home Care | Home Health | 3000 Logan Ave N, Minneapolis, MN 55411 | 2013-05-30 |
| 1154766525 | Bassim Samadani Birkland | Student in an Organized Health Care Education/Training Program | Broadway Clinic, 1020 West Broadway, Minneapolis, MN 55411 | 2013-04-30 |
| 1720354004 | New Salem Metormorphosis Youth Program | Counselor | 2509 Bryant Ave North, Minneapolis, MN 55411 | 2012-03-30 |
| 1629387469 | Apose | Home Health | 2806 Girard Ave. North, Minneapolis, MN 55411 | 2010-09-28 |
| Find all providers in zip 55411 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336594498 | Jaimi Weber | Family Medicine | Mmc 381, 420 Delaware St. Se, Minneapolis, MN 55445 | 2016-04-26 |
| 1376906388 | Sama Healthcare | Family Medicine | 2639 Nicollet Ave., Suite 130, Minneapolis, MN 55408 | 2016-03-29 |
| 1902209687 | Elaine May | Family Medicine | 2861 Burnham Blvd, Minneapolis, MN 55416-4331 | 2014-10-08 |
| 1952741050 | Gregory Olszewski | Family Medicine | 19 S 1st St Apt B2603, Minneapolis, MN 55401-1845 | 2013-07-03 |
| 1881940864 | Isaac Milton Engholm | Family Medicine | 825 Nicollet Mall Ste 403, Minneapolis, MN 55402-2611 | 2012-07-27 |
| 1942572763 | Neighborhood Healthsource | Family Medicine | 1015 4th Avenue North, Suite 201, Minneapolis, MN 55405-1178 | 2012-02-09 |
| 1225323371 | Yun Chau Bernice Lee | Family Medicine | 2823 Dean Pkwy, Minneapolis, MN 55416-4401 | 2011-06-16 |
| 1730487208 | Specialized Medical Response, LLC | Family Medicine | 401 Harding St Ne #100, Minneapolis, MN 55413 | 2011-03-08 |
| 1285930065 | Allina Health System | Family Medicine | 3024 Snelling Ave S, Minneapolis, MN 55406-1911 | 2011-01-27 |
| 1013226844 | Corban Health Care, Pllc | Family Medicine | 5141 36th Ave S, Minneapolis, MN 55417-1518 | 2010-09-28 |
| Find all providers in MINNEAPOLIS | ||||
| City | MINNEAPOLIS |
| Zip Code | 55411 |
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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.