MR. DEREK K GROENEWEG (NPI# 1255888772) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255888772 |
| Entity Type | Individual |
| Full Name | MR. DEREK K GROENEWEG |
| Credential | PA |
| Practice Address |
300 S Bruce St Marshall MN 56258-1934 |
| Practice Telephone | 5075379007 |
| Practice Fax Number | 5075372734 |
| Mailing Telephone | 5075379007 |
| Mailing Fax Number | 5075372734 |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2016-10-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
2598 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
300 S BRUCE ST |
| City | MARSHALL |
| State | MN |
| Zip Code | 56258-1934 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922003409 | Alain Desy | Orthopaedic Surgery | 300 S Bruce St, Marshall, MN 56258-1934 | 2005-06-20 |
| 1336750702 | Neil Thomas Eichten | Speech-Language Pathologist | 300 S Bruce St, Marshall, MN 56258-1934 | 2020-08-11 |
| 1427669894 | Victoria Ann Botten | Speech-Language Pathologist | 300 S Bruce St, Marshall, MN 56258-1934 | 2020-08-11 |
| 1811506694 | Kendall Drew Hines | Physical Therapist | 300 S Bruce St, Marshall, MN 56258-1934 | 2020-07-28 |
| 1053934877 | Karen Marie Kersting | Physical Therapist | 300 S Bruce St, Marshall, MN 56258-1934 | 2020-05-27 |
| 1306474747 | Ramy Vandendriessche | Physical Therapist | 300 S Bruce St, Marshall, MN 56258-1934 | 2020-03-31 |
| 1114576535 | Analisa Kay Buysse | Pharmacist | 300 S Bruce St, Marshall, MN 56258-1934 | 2019-09-09 |
| 1346894748 | Jacob Bottelberghe | Physician Assistant | 300 S Bruce St, Marshall, MN 56258-1934 | 2019-07-25 |
| 1598224321 | Hannah Sue Reski | Physician Assistant | 300 S Bruce St, Marshall, MN 56258-1934 | 2019-03-19 |
| 1245709443 | Amy Marie Meyeraan-rowe | Nurse Practitioner | 300 S Bruce St, Marshall, MN 56258-1934 | 2018-11-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285140012 | Action Manufacturing Inc | Durable Medical Equipment & Medical Supplies | 1105 Lake Road, Marshall, MN 56258 | 2017-12-15 |
| 1124579123 | Themarshrx | Durable Medical Equipment & Medical Supplies | 600 Sherman Ave, Marshall, MN 56258 | 2016-10-14 |
| 1780020370 | Heritage Pointe Senio | Assisted Living Facility | 207 N 4th Street, Marshall, MI 56258 | 2013-05-22 |
| 1528351178 | Lori Anne Lynner | Family Medicine | 3160 Us Hwy 59, Marshall, MN 56258 | 2011-05-16 |
| 1912148545 | Tami J Behnke | Counselor | 1418 State Street, Campus Religious Center, Marshall, MN 56258 | 2009-03-11 |
| 1073768396 | Sharyce Marie Audiology Inc | Audiologist | 1424 East College Drive, Suite 200, Marshall, MN 56258 | 2008-12-01 |
| 1497976625 | Erica Anne Jost | Specialist/Technologist | 1501 State Street, Marshall, MN 56258 | 2007-05-02 |
| 1265597470 | Nancy Louise Hemmingson | Optometrist | 300 S Bruce Street, Avera Marshall Southwest Ophthalmology, Marshall, MN 56258 | 2006-12-27 |
| 1407928187 | Midwest Vision Centers Inc | Technician/Technologist | 1113 E College Drive, Marshall, MN 56258 | 2006-11-15 |
| 1306918354 | Paul Joseph Puetz | Chiropractor | 111 Jewett St, Marshall, MN 56258 | 2006-11-14 |
| Find all providers in zip 56258 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194120204 | Nathan C Clapper | Physician Assistant | 3580 Arcade St Ste 100, Vadnais Heights, MN 55127-7135 | 2014-10-31 |
| 1003180555 | Elizabeth K Saterenzoller | Physician Assistant | 1015 Marsh Street, Mankato, MN 56002-8673 | 2012-03-01 |
| 1477824472 | Andrea Jo Pitzl | Physician Assistant | 3208 36th Ave Ne, St Anthony, MN 55418-1713 | 2012-01-23 |
| 1447560693 | Jeanine Marie Edstrom | Physician Assistant | 1185 Town Centre Dr Ste 200, Eagan, MN 55123-1343 | 2010-10-20 |
| 1841504792 | Michelle R Aumock | Physician Assistant | 8100 W 78th Street, Ste 230, Edina, MN 55439 | 2010-08-03 |
| 1194042390 | Gerald Frederick Anderson | Physician Assistant | 4060 Haines Rd, #104, Duluth, MN 55811-1746 | 2010-04-27 |
| 1558683904 | Oswaldo Serge | Physician Assistant | 4036 3rd St Nw, Rochester, MN 55901-7564 | 2010-02-25 |
| 1417288945 | Amanda Kay Johnson | Physician Assistant | 201 W Center St Ei-01 Surgical Assistant, Rochester, MN 55902-3003 | 2010-01-22 |
| 1790922755 | Jenelle Cecilia Rock | Physician Assistant | 1950 Northwestern Ave S, Suite 102, Stillwater, MN 55082-7590 | 2009-01-13 |
| 1174775514 | Nathan J Nistler | Physician Assistant | 3580 Arcade Stq, Vadnais Heights, MN 55127-7135 | 2008-10-16 |
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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.