FERGUS FALLS MEDICAL GROUP, P.A. (NPI# 1285676031) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285676031 |
| Entity Type | Organization |
| Organization Name | FERGUS FALLS MEDICAL GROUP, P.A. |
| Practice Address |
615 S Mill St Fergus Falls MN 56537-2756 |
| Practice Telephone | 2187392221 |
| Practice Fax Number | 2187395501 |
| Mailing Telephone | 2187392221 |
| Mailing Fax Number | 2187395501 |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2009-03-26 |
| Authorized Official Name | JOHN PETERSON (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 2187392221 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
44 | MN | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | FFMG UCARE # | 109516 | 01 |
| MN | 533810700 | 05 | |
| MN | FFMG BCBS # | 62345FE | 01 |
| ND | 10344 | 05 | |
| MN | FFMG MEDICA # | 00-01587 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982649216 | Fergus Falls Medical Group, P.a. | Clinic/Center | 204 5th Street E, Herman, MN 56248-0304 | 2006-06-19 |
| 1750326070 | Fergus Falls Medical Group, P.a. | Clinic/Center | 404 West Broadway, Brown's Valley, MN 56219 | 2006-06-19 |
| 1376587972 | Fergus Falls Medical Group, P.a. | Clinic/Center | 410 Lake Ave S, Battle Lake, MN 56515 | 2006-06-15 |
| 1619915543 | Fergus Falls Medical Group, P.a. | Clinic/Center | 403 12th St N, Wheaton, MN 56296-1070 | 2006-06-03 |
| 1134167166 | Fergus Falls Medical Group, P.a. | Clinic/Center | 405 Main St, Ashby, MN 56309-4659 | 2006-06-03 |
| 1730127812 | Fergus Falls Medical Group, P.a. | Family Medicine | 2001 W Lincoln Ave, Suite 56, Fergus Falls, MN 56537-1010 | 2006-06-02 |
| Street Address |
615 S MILL ST |
| City | FERGUS FALLS |
| State | MN |
| Zip Code | 56537-2756 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619972734 | 20-20 Optical Inc | Technician/Technologist | 615 S Mill St, Ste 2, Fergus Falls, MN 56537-2756 | 2005-06-15 |
| 1801221676 | Dan Kwapinski | Pharmacist | 615 S Mill St, Fergus Falls, MN 56537-2756 | 2013-09-11 |
| 1831401058 | Naomi Destaffany Schmid | Podiatrist | 615 S Mill St, Fergus Falls, MN 56537-2756 | 2010-07-02 |
| 1437487105 | Lorri Holt | Technician/Technologist | 615 S Mill St, Suite 2, Fergus Falls, MN 56537-2756 | 2009-11-18 |
| 1922336601 | Amy Donoho | Technician/Technologist | 615 S Mill St, Suite 2, Fergus Falls, MN 56537-2756 | 2009-11-18 |
| 1720316409 | David G Gaustad | Technician/Technologist | 615 S Mill St, Suite 2, Fergus Falls, MN 56537-2756 | 2009-11-18 |
| 1083942775 | Barbara L Johnson | Technician/Technologist | 615 S Mill St, Suite 2, Fergus Falls, MN 56537-2756 | 2009-11-18 |
| 1033447719 | Sheila Rodning | Technician/Technologist | 615 S Mill St, Suite 2, Fergus Falls, MN 56537-2756 | 2009-11-18 |
| 1962730648 | Kathryn Polejewski | Technician/Technologist | 615 S Mill St, Suite 2, Fergus Falls, MN 56537-2756 | 2009-11-18 |
| 1982932646 | Randa Jean Wik | Technician/Technologist | 615 S Mill St, Suite 2, Fergus Falls, MN 56537-2756 | 2009-11-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295334217 | Mary Jane Andersen | Pharmacist | 3300 Hwy 210 W, Fergus Falls, MN 56537 | 2020-10-21 |
| 1609475615 | Blaine Perry Ecker | Pharmacist | 3300 Highway 210 W., 3300 Highway 210 West, Fergus Falls, MN 56537 | 2020-10-21 |
| 1336771591 | Paul George Wawin | Psychiatry & Neurology | 712 Cascade St. S. Lake Region Healthcare, Fergus Falls, MN 56537 | 2020-02-06 |
| 1134604127 | Christopher Michael Kjolhaug | Physical Therapist | 1131 South Mabelle Ave, Fergus Falls, MN 56537 | 2018-09-26 |
| 1619406808 | Aaron John Teigen | Physical Therapist | 1304 Lincoln Ave W, Suite C, Fergus Falls, MN 56537 | 2017-06-09 |
| 1003272154 | Anthony Gettel Dc LLC | Chiropractor | 755 Wildwood Trail, Fergus Falls, MN 56537 | 2016-01-05 |
| 1447628912 | Kelsey Shea | Student in an Organized Health Care Education/Training Program | 20743 Red Oak Dr., Fergus Falls, MN 56537 | 2015-09-14 |
| 1881070217 | Vineet Ganapati | Dentist | 2001 W Lincoln Ave # 33, Fergus Falls, MN 56537 | 2015-08-07 |
| 1497004832 | Beverly Renae Reiff | Registered Nurse | 22279 River Oaks Drive, Fergus Falls, MN 56537 | 2012-08-30 |
| 1114221421 | Jane Mary Bjornson | Social Worker | 21081 County Hwy 1, Fergus Falls, MN 56537 | 2010-12-29 |
| Find all providers in zip 56537 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992224331 | Orthopedic & Sports Physical Therapy, Inc. | Clinic/Center | 322 N Tower Rd, Fergus Falls, MN 56537-1015 | 2017-09-18 |
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| 1689161077 | Chs Tennessee Medical P C | Clinic/Center | 701 Brooks Ave S, Thief River Falls, MN 56701-2757 | 2018-04-20 |
| 1427557867 | Gillette Children's Specialty Healthcare | Clinic/Center | 505 Paul Bunyan Dr Nw, Bemidji, MN 56601-2400 | 2018-02-11 |
| 1003339789 | Centracare Clinic | Clinic/Center | 2025 Stearns Way Ste 114, Saint Cloud, MN 56303 | 2017-07-25 |
| 1063942977 | Deer River Healthcare Center Inc | Clinic/Center | 1542 Golf Course Rd Ste 202, Grand Rapids, MN 55744-3557 | 2017-06-13 |
| Find all providers with the same taxonomy | ||||
| City | FERGUS FALLS |
| Zip Code | 56537 |
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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.