CHARLES RUSSELL HEAGLE (NPI# 1205998242) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205998242 |
| Entity Type | Individual |
| Full Name | CHARLES RUSSELL HEAGLE |
| Credential | MD |
| Practice Address |
470 W 78th St Suite 250 Chanhassen MN 55317 |
| Mailing Address |
Po Box 84 Waconia MN 55387 |
| Practice Telephone | 9529343296 |
| Practice Fax Number | 9529061737 |
| Mailing Telephone | 9529343296 |
| Mailing Fax Number | 9529061737 |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 202K00000X | Phlebology | 17725 | MN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | MEDICA | 0104890 | 01 |
| Street Address |
470 W 78TH ST SUITE 250 |
| City | CHANHASSEN |
| State | MN |
| Zip Code | 55317 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396747937 | Elizabeth Burns | Nurse Practitioner | 470 W 78th St, Suite 250, Chanhassen, MN 55317-4524 | 2005-08-12 |
| 1760802722 | Dentalign, P.a | Dentist | 470 W 78th St, Chanhassen, MN 55317-4524 | 2014-04-17 |
| 1043540966 | Miranda Mcdonald | Acupuncturist | 470 W 78th St, Suite 120, Chanhassen, MN 55317-4524 | 2009-12-29 |
| 1922158211 | Robert James Lindsey | Chiropractor | 470 W 78th St, Suite 120, Chanhassen, MN 55317-4524 | 2007-01-11 |
| 1407918444 | Melanie Clare Murn | Phlebology | 470 W 78th St, Ste 250, Chanhassen, MN 55317 | 2006-12-15 |
| 1669534608 | Vein Clinic Pa | Clinic/Center | 470 W 78th St, Ste 250, Chanhassen, MN 55317 | 2006-12-15 |
| 1053422436 | Joseph A Fiedler | Dentist | 470 W 78th St, Suite #200, Chanhassen, MN 55317 | 2006-08-31 |
| 1659304053 | Nrg Chiropractic Pa | Chiropractor | 470 W 78th St, Suite 120, Chanhassen, MN 55317 | 2006-07-09 |
| 1073550018 | Katie Mae Murphy | Chiropractor | 470 W 78th St, Ste 120, Chanhassen, MN 55317 | 2006-05-31 |
| 1942265434 | Surgical Specialties, Ltd. | Specialist | 470 W 78th St, Chanhassen, MN 55317-4524 | 2006-04-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801245717 | Thaddeus Sharikov | Chiropractor | 7945 Stone Creek Dr. Ste 120, Chanhassen, MN 55317 | 2016-06-10 |
| 1720461668 | Steven C Witmer | Counselor | Northstar Regional Counseling, 7945 Stone Creek Drive Suite 140, Chanhassen, MN 55317 | 2015-07-08 |
| 1194078584 | Kentaro Ishikawa | Dentist | 190 Lake Dr E, Ste 130, Chanhassen, MN 55317 | 2012-10-22 |
| 1356559983 | Rtgmedical | General Acute Care Hospital | 2186 Baneberry Way W, Chanhassen, MN 55317 | 2007-05-18 |
| 1528273299 | Cam-tu Nguyen Dalluge | Dentist | 500 West 79th Street, Radiance Dental, Chanhassen, MN 55317 | 2007-05-14 |
| 1194938910 | Sheri Hinrichs | Psychologist | 600 W. 78th St. #220, Chanhassen, MN 55317 | 2007-05-08 |
| 1891833059 | Great Plains Dental | Dentist | 500 W 79th St, Chanhassen, MN 55317 | 2007-02-01 |
| 1073665014 | Judith Aarsvold Indrelie | Psychologist | 600 West 78th Street, Chanhassen, MN 55317 | 2007-01-18 |
| 1285709410 | Diane Patricia O'grady | Psychiatry & Neurology | 7945 Stone Creek Drive, Suite 130, Chanhassen, MN 55317 | 2006-11-22 |
| 1114097425 | Michael Jeffery Leonard | Dentist | 80 West 78th Street, Chanhassen, MN 55317 | 2006-11-08 |
| Find all providers in zip 55317 | ||||
| Taxonomy Code | 202K00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Phlebology |
| Phlebology is the medical discipline that involves the diagnosis and treatment of venous disorders, including spider veins, varicose veins, chronic venous insufficiency, venous leg ulcers, congenital venous abnormalities, venous thromboembolism and other disorders of venous origin. A phlebologist has attained a minimum of 50 hours of CME units in phlebology-related courses, and is knowledgeable of and trained in a variety of diagnostic techniques including physical examination, venous imaging techniques such as duplex ultrasound, CT and MR, plethysmographic techniques and laboratory evaluation related to venous thromboembolism. The phlebologist is also trained in a variety of therapeutic interventions, which may include compression, sclerotherapy, cutaneous vascular laser, endovenous thermoablation procedures (laser and radiofrequency) endovenous chemical ablation, surgical procedures (e.g., ambulatory phlebectomy, venous ligation), vasoactive medications and the management of venous thromboembolism. |
| Notes: Source: American College of Phlebology 12/2006. www.phelbology.org [1/1/2007: new, 7/1/2009: definition reformatted] Additional Resources: Training Programs, Fellowships, and/or Preceptorships: Certification exam is being established by the American Board of Phlebology. ACGME Accredited Residency Program Requirements: None |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407918444 | Melanie Clare Murn | Phlebology | 470 W 78th St, Ste 250, Chanhassen, MN 55317 | 2006-12-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912566563 | Minnesota Vein Specialists | Phlebology | 7365 Kirkwood Ct N Ste 120, Maple Grove, MN 55369-4781 | 2019-06-07 |
| 1184098717 | Jrk Medicals | Phlebology | 1650 4th St Se, Rochester, MN 55904-4717 | 2015-11-19 |
| 1962849943 | Rsmn PC | Phlebology | 2801 Wayzata Blvd, Minneapolis, MN 55405-2125 | 2013-05-30 |
| City | CHANHASSEN |
| Zip Code | 55317 |
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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.