ST. LUKE'S HOSPITAL OF DULUTH (NPI# 1275587974) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275587974 |
| Entity Type | Organization |
| Organization Name | ST. LUKE'S HOSPITAL OF DULUTH |
| Other Organization Name | ST. LUKE'S PLASTIC SURGERY ASSOCIATES |
| Practice Address |
1012 E 2nd St Duluth MN 55805-2200 |
| Practice Telephone | 2182497910 |
| Mailing Telephone | 2182497910 |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2020-01-28 |
| Authorized Official Name | MR. KEVIN NOKELS (PRESIDENT, CEO) |
| Authorized Official Telephone | 2182495389 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208200000X | Plastic Surgery | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| St. Luke's Plastic Surgery Associates | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497087126 | St. Luke's Hospital of Duluth | Family Medicine | 6351 E. Superior St., Duluth, MN 55804-2545 | 2010-02-05 |
| 1083668784 | St. Luke's Hospital of Duluth | Surgery | 920 E 1st St Ste 302, Duluth, MN 55805 | 2006-05-19 |
| 1063464154 | St. Luke's Hospital of Duluth | Family Medicine | 8373 Unity Drive, Virginia, MN 55792-4005 | 2006-05-17 |
| 1316999485 | St. Luke's Hospital of Duluth | Family Medicine | 2201 Lake Shore Drive East, Ashland, WI 54806-2331 | 2006-05-17 |
| 1952926206 | St. Luke's Hospital of Duluth | Durable Medical Equipment & Medical Supplies | 1012 E 2nd St, Duluth, MN 55805-2200 | 2020-06-12 |
| 1689200578 | St. Luke's Hospital of Duluth | Hospitalist | 915 E 1st St, Duluth, MN 55805-2193 | 2020-03-23 |
| 1336774165 | St. Luke's Hospital of Duluth | Durable Medical Equipment & Medical Supplies | 915 E 1st St, Duluth, MN 55805-2193 | 2020-03-12 |
| 1275005498 | St. Luke's Hospital of Duluth | Clinic/Center | 1000 E 1st St Ste 204, Duluth, MN 55805-2297 | 2018-12-28 |
| 1205319662 | St. Luke's Hospital of Duluth | Durable Medical Equipment & Medical Supplies | 930 E 2nd St, Duluth, MN 55805-2104 | 2018-09-12 |
| 1528505955 | St. Luke's Hospital of Duluth | Internal Medicine | 1001 E Superior St, Ste. L201, Duluth, MN 55802-2207 | 2017-01-24 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | ST. LUKE'S HOSPITAL OF DULUTH | 915 E First St, Duluth, MN 55805-2107 |
| Street Address |
1012 E 2ND ST |
| City | DULUTH |
| State | MN |
| Zip Code | 55805-2200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588669253 | Douglas W Kaplan | Psychiatry & Neurology | 1012 E 2nd St, Duluth, MN 55805-2200 | 2005-06-17 |
| 1952926206 | St. Luke's Hospital of Duluth | Durable Medical Equipment & Medical Supplies | 1012 E 2nd St, Duluth, MN 55805-2200 | 2020-06-12 |
| 1942777529 | Cody Thomas Lemay | Physician Assistant | 1012 E 2nd St, Duluth, MN 55805-2200 | 2018-10-31 |
| 1619453032 | Katrina Jean Hough | Specialist/Technologist | 1012 E 2nd St, Duluth, MN 55805-2200 | 2018-07-18 |
| 1164977468 | Chelsea Ruda | Physician Assistant | 1012 E 2nd St, Duluth, MN 55805 | 2016-08-17 |
| 1437509874 | Leslie Adrian | Emergency Medicine | 1012 E 2nd St, Duluth, MN 55805-2200 | 2016-06-16 |
| 1811343973 | Carley Jean Udland | Pediatrics | 1012 E 2nd St, Duluth, MN 55805 | 2016-05-09 |
| 1841651437 | Ashley Marie Chesney | Physician Assistant | 1012 E 2nd St, Duluth, MN 55805-2200 | 2016-03-10 |
| 1982062550 | St. Luke's Hospital of Duluth | Pain Medicine | 1012 E 2nd St, Duluth, MN 55805-2200 | 2016-02-10 |
| 1073907291 | Jordan Blessing | Pediatrics | 1012 E 2nd St, Duluth, MN 55805 | 2015-03-25 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356852180 | Peace of Mind of Duluth, Inc. | Community/Behavioral Health | 1000 East 1st Street, Suite 100, Duluth, MN 55805 | 2017-10-19 |
| 1891213419 | Arielle Skalisky | Registered Nurse | 400 E. 3rd Street, Duluth, MN 55805 | 2017-09-04 |
| 1457886400 | Chefrdn, LLC | Dietitian, Registered | 1101 East 4th Street, Duluth, MN 55805 | 2017-04-27 |
| 1962811604 | Claire Elena Kap | Nurse Practitioner | Essentia Health Duluth Clnic, 400 East Third Street, Duluth, MN 55805 | 2014-08-06 |
| 1598196313 | Kelsey Lindsay Putvin | Audiologist | 400 E 3rd St., Duluth, MN 55805 | 2013-12-04 |
| 1639462997 | James F Conniff | Family Medicine | Duluth Family Medicine Clinic, 330 N Eighth Ave E, Duluth, MN 55805 | 2011-05-19 |
| 1215237433 | Bobby Jo Mineheine | Speech-Language Pathologist | 530 East Second St, Polinsky Medical Rehab Ctr, Duluth, MN 55805 | 2010-10-22 |
| 1891004248 | Robin Michelle Warfel | Occupational Therapist | 530 East 2nd Street, Polinsky Medical Rehabilitation Center, Duluth, MN 55805 | 2010-10-04 |
| 1154638716 | Jennifer Chen | Pharmacist | 420 E 1st St Mail Drop 1s3w10, Duluth, MN 55805 | 2010-09-02 |
| 1376858084 | Jennifer Lynn Howard | Pharmacist | 211 West Fourth Street, Center for American Indian Resources, Duluth, MN 55805 | 2010-08-18 |
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| Taxonomy Code | 208200000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Plastic Surgery |
| A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Plastic Surgery, 2007. http://www.abplsurg.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Plastic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851690697 | Jason Dean Fowler | Plastic Surgery | 1420 London Rd Ste 101, Duluth, MN 55805-2437 | 2011-03-18 |
| 1598923021 | Lisa Carolyn Moody | Plastic Surgery | 3540 Duluth Park Ln Ste 290, Duluth, GA 30096-8511 | 2008-05-31 |
| 1962502252 | Phillip Hiroto Nakano | Plastic Surgery | 3096 Peachtree Industrial Blvd, Duluth, GA 30097-7918 | 2006-09-25 |
| 1043260557 | Edgar F. Saldana | Plastic Surgery | 324 W Superior St Ste 100, Duluth, MN 55802-1763 | 2006-05-12 |
| 1982668497 | Andrew Jimerson II | Plastic Surgery | 6620 Mcginnis Ferry Rd, Duluth, GA 30097-1542 | 2006-04-12 |
| 1558988477 | Plastic Surgery Center of Duluth Pllc | Plastic Surgery | 324 W Superior St Ste 100, Duluth, MN 55802-1763 | 2020-06-26 |
| 1235379256 | Wade Daniel Kubat | Plastic Surgery | 1012 E 2nd St, Duluth, MN 55805-2200 | 2009-03-03 |
| 1427237767 | Advanced Plastic Surgery Solutions, LLC | Plastic Surgery | 6630 Mcginnis Ferry Rd, Suite B, Duluth, GA 30097-1542 | 2007-11-02 |
| 1063502375 | Hanjoon Mike Song | Plastic Surgery | 3096 Peachtree Industrial Blvd, Duluth, GA 30097 | 2006-10-15 |
| 1871688317 | James Clinton Cronan Jr. | Plastic Surgery | 3400 Mcclure Bridge Rd, Building B201, Duluth, GA 30096-6675 | 2006-10-03 |
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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.