MINNESOTA STATE UNIVERSITY-MOORHEAD (NPI# 1306384649) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306384649 |
| Entity Type | Organization |
| Organization Name | MINNESOTA STATE UNIVERSITY-MOORHEAD |
| Practice Address |
1104 7th Ave S Moorhead MN 56563-0001 |
| Practice Telephone | 2184772385 |
| Mailing Telephone | 2184772385 |
| Enumeration Date | 2017-02-07 |
| Last Update Date | 2017-02-07 |
| Authorized Official Name | MRS. MICHELLE MARIAN IVERSON (SPEECH LANGUAGE PATHOLOGIST) |
| Authorized Official Telephone | 2184772385 |
| Authorized Official Credential | MS; CCC-SLP |
| Is Organization Subpart | Y |
| Parent Organization Name | MINNESOTA STATE COLLEGES AND UNIVERSITIES |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | 5512 | MN | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | MDE LICENSE | 5512 | 01 |
| Street Address |
1104 7TH AVE S |
| City | MOORHEAD |
| State | MN |
| Zip Code | 56563-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457325763 | Christopher Jason Huot | Specialist/Technologist | 1104 7th Ave S, 106 C Nemzek Hall, Moorhead, MN 56563-0001 | 2006-02-14 |
| 1144799875 | Chikara Hiraoka | Specialist/Technologist | 1104 7th Ave S, Moorhead, MN 56563-0001 | 2018-11-26 |
| 1497109276 | Adam Aune | Specialist/Technologist | 1104 7th Ave S, Moorhead, MN 56563-0001 | 2016-04-19 |
| 1376929513 | Jill Marie Beuckens | Speech-Language Pathologist | 1104 7th Ave S, Msum Box 119, Moorhead, MN 56563-0001 | 2015-08-10 |
| 1942697156 | Sarah Drusch | Specialist/Technologist | 1104 7th Ave S, Moorhead, MN 56563-0001 | 2015-04-26 |
| 1336569748 | Jay Michael Albrecht | Specialist/Technologist | 1104 7th Ave S, Minnesota State University Moorhead, Moorhead, MN 56563-0001 | 2014-04-24 |
| 1346672391 | Lisa Karch | Counselor | 1104 7th Ave S, Moorhead, MN 56563-0001 | 2013-08-01 |
| 1154602423 | Michelle Grace Tranby | Massage Therapist | 1104 7th Ave S, Moorhead, MN 56563-0001 | 2011-08-31 |
| 1558508341 | Benjamin L Erie | Counselor | 1104 7th Ave S, Lommen Hall 113, Moorhead, MN 56563-0001 | 2009-01-15 |
| 1326176439 | Hendrix Health Center Pharmacy | Pharmacist | 1104 7th Ave S, Moorhead, MN 56563-0001 | 2007-03-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346658549 | Charles Meek | Specialist/Technologist | Minnesota State University Moorhead, Nemzek Hall Room 125, Moorhead, MN 56563 | 2014-07-31 |
| 1073648259 | Allan James Luistro | Family Medicine | 1104 7th Ave S., Box 92 Msum Hendrix Clinic & Counseling Center, Moorhead, MN 56563 | 2007-02-21 |
| 1356378848 | Keith Allen Wiedrich | Specialist/Technologist | 1107 7th St. S., Msu Moorhead - Athletics, Moorhead, MN 56563 | 2006-06-28 |
| 1235103284 | Ronda K Peterson | Specialist/Technologist | 125 Nemzek, Msum, Moorhead, MN 56563 | 2006-02-15 |
| 1124092176 | Andrea Lynn Scott | Specialist/Technologist | Nemzek 125, Minnesota State University Moorhead, Moorhead, MN 56563 | 2006-02-15 |
| 1891906202 | Joni K Mehrhoff | Speech-Language Pathologist | 1104 7th Ave South, Moorhead, MN 56563 | 2007-05-25 |
| 1982162434 | Family Health Care Center | Clinic/Center | 1104 7th Ave S # 92, Moorhead, MN 56563-0001 | 2019-03-04 |
| 1659688034 | Maribeth Kay Plankers | Speech-Language Pathologist | 1104 7th Avenue South, Msum, Moorhead, MN 56563-0001 | 2010-09-08 |
| 1700119351 | Elaine K. Pyle | Speech-Language Pathologist | 1104 7th Ave. South, Msum Box 119, Moorhead, MN 56563-0001 | 2009-09-15 |
| 1073605697 | Bruce R Hanson | Speech-Language Pathologist | 1104 7th Ave South, Msum Box 119, Moorhead, MN 56563-0001 | 2006-09-29 |
| Find all providers in zip 56563 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780168054 | Beths Place LLC | Clinic/Center | 1606 30th Ave S Ste 2, Moorhead, MN 56560-5147 | 2018-09-21 |
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| 1992320014 | Jtp Professional Service Corporation | Clinic/Center | 2038 Ford Pkwy # 444, Saint Paul, MN 55116-1931 | 2020-06-15 |
| 1689299125 | Altru Health System | Clinic/Center | 1st & Roosevelt, Karlstad, MN 56732 | 2020-06-10 |
| 1831710409 | Webmed LLC | Clinic/Center | 925 E Superior St Ste 113, Duluth, MN 55802-2253 | 2020-05-05 |
| 1073149779 | Functional Chiropractic Rehab, Pllc | Clinic/Center | 1901 Madison Ave Ste 120, Mankato, MN 56001-6267 | 2020-03-14 |
| 1225676067 | Liana Healthcare P.ll.c | Clinic/Center | 8348 Beard Rd, Bloomington, MN 55431-1028 | 2019-12-11 |
| 1245875293 | Fairview Clinics | Clinic/Center | 12912 Farnham Ave N, White Bear Lake, MN 55110-5929 | 2019-11-14 |
| 1275175242 | Hye-kyong Kim Therapy LLC | Clinic/Center | 1145 Grand Ave # 101, Saint Paul, MN 55105-2629 | 2019-10-11 |
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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.