RICHARD PETER CERVENKA (NPI# 1306832464) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306832464 |
| Entity Type | Individual |
| Full Name | RICHARD PETER CERVENKA |
| Credential | DPM |
| Practice Address |
3790 117th Ln Nw Coon Rapids MN 55433-2666 |
| Practice Telephone | 7634217300 |
| Practice Fax Number | 7634213337 |
| Mailing Telephone | 7634217300 |
| Mailing Fax Number | 7634213337 |
| Enumeration Date | 2005-09-23 |
| Last Update Date | 2017-05-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0131X |
Podiatrist Specialization: Foot Surgery |
304 | MN | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 042325400 | 05 | |
| MN | BC | 34039CE | 01 |
| Street Address |
3790 117TH LN NW |
| City | COON RAPIDS |
| State | MN |
| Zip Code | 55433-2666 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275534885 | Family Foot and Ankle Clinic, Pa | Podiatrist | 3790 117th Ln Nw, Coon Rapids, MN 55433-2666 | 2005-08-04 |
| 1922481761 | Christopher Aaron Neese | Podiatrist | 3790 117th Ln Nw, Coon Rapids, MN 55433 | 2015-06-29 |
| 1497195226 | Keith A Canter | Podiatrist | 3790 117th Ln Nw, Coon Rapids, MN 55433-2666 | 2013-06-25 |
| 1912908435 | Jeffrey Lee Mich | Podiatrist | 3790 117th Ln Nw, Coon Rapids, MN 55433-2666 | 2005-08-09 |
| 1578564092 | David Joseph Neese | Podiatrist | 3790 117th Ln Nw, Coon Rapids, MN 55433-2666 | 2005-08-09 |
| 1619978103 | Scott Bernard Saxe | Podiatrist | 3790 117th Ln Nw, Coon Rapids, MN 55433-2666 | 2005-08-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770134793 | Shelley Karee Peterson | Technician | 10311 Bittersweet St Nw, Coon Rapids, MN 55433 | 2019-09-20 |
| 1578122057 | Courtney Gau | Behavior Technician | Fraser Coon Rapids, 9120 Springbrook Dr. Nw, Coon Rapids, MN 55433 | 2019-06-10 |
| 1992275606 | Maliki Fofee Kamara | Licensed Practical Nurse | 2451 109th Ave Nw Apt. 1, Coon Rapids, MN 55433 | 2018-11-26 |
| 1992284541 | Sarah Vennes | Massage Therapist | 6400 Flying Cloud Dr, Suite 240, Eden Prairie, MN 55433 | 2018-08-13 |
| 1538646609 | Paige Prince | Behavior Technician | Fraser Coon Rapids, 9120 Springbrook Drive Nw, Coon Rapids, MN 55433 | 2018-07-23 |
| 1154828242 | Karin Lea Englund | Dentist | 9145 Springbrook Dr Nw Ste 100, Coon Rapids, MN 55433 | 2018-04-06 |
| 1235642513 | Vista Family Eye Care LLC | Optometrist | 9920 Foley Blvd Nw Ste 120, Coon Rapids, MN 55433 | 2017-11-09 |
| 1538697818 | Mohammed Nmn Ahmed | Internal Medicine | 9055 Spring Brook Drive, Allina Coon Rapids Clinic 9055, Coon Rapids, MN 55433 | 2017-05-31 |
| 1639531353 | Journi LLC | Nurse Practitioner | 277 Coon Rapids Blvd Suite 308, Coon Rapids, MN 55433 | 2016-03-22 |
| 1821457722 | Honorine Boyce | Licensed Practical Nurse | 2743 111th Ave. Nw, Coon Rapids, MN 55433 | 2016-02-19 |
| Find all providers in zip 55433 | ||||
| Taxonomy Code | 213ES0131X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700098613 | Winona Foot Clinic P.a. | Podiatrist | 350 East Sarnia Street, Winona, MN 55987 | 2007-05-04 |
| 1215149364 | John M Enger, Professional Association | Podiatrist | 904 E Plaza Street, Albert Lea, MN 56007 | 2007-05-03 |
| 1710083837 | Medical Arts Foot Clinics, P. A. | Podiatrist | 3485 Willow Lake Blvd, Suite 300, Saint Paul, MN 55110-5152 | 2006-09-16 |
| 1205856713 | Dale Herbert Vancil | Podiatrist | 3485 Willow Lake Blvd., Suite 300, Lino Lakes, MN 55110-5152 | 2006-07-20 |
| 1639150774 | Otter Tail Podiatry Associates, P.a. | Podiatrist | 120 E Junius Ave, Fergus Falls, MN 56537-2819 | 2005-11-07 |
| 1497145262 | David Edward Jones | Podiatrist | 5861 Cedar Lake Rd S, Minneapolis, MN 55416-1653 | 2015-01-30 |
| 1912271180 | Kari Prescott, D P M P A | Podiatrist | 825 Nicollet Mall, Suite 441, Minneapolis, MN 55402-2606 | 2012-03-05 |
| 1952612418 | Corey Edward Valentine | Podiatrist | 301 Highway 65 S, Mora, MN 55051-1899 | 2010-06-29 |
| 1053639732 | Melanie Johnson | Podiatrist | 4653 White Bear Pkwy, White Bear Lake, MN 55110 | 2010-05-05 |
| 1154559144 | Conrad L Meints & Associate | Podiatrist | 324 W Superior St, Suite 517, Duluth, MN 55802-1760 | 2009-06-29 |
| Find all providers with the same taxonomy | ||||
| City | COON RAPIDS |
| Zip Code | 55433 |
Please comment or provide details below to improve the information on RICHARD PETER CERVENKA.
| 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.