ST. LUKE'S HOSPITAL OF DULUTH (NPI# 1306870654) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306870654 |
| Entity Type | Organization |
| Organization Name | ST. LUKE'S HOSPITAL OF DULUTH |
| Other Organization Name | P. S. RUDIE MEDICAL CLINIC |
| Practice Address |
26 E Superior St Ste 205 Duluth MN 55802-2196 |
| Practice Telephone | 2182494300 |
| Practice Fax Number | 2182494350 |
| Mailing Telephone | 2182494300 |
| Mailing Fax Number | 2182494350 |
| Enumeration Date | 2006-07-11 |
| 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 | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | BCBSMN | 36P16RU | 01 |
| Other Name | Type Code |
|---|---|
| P. S. Rudie Medical Clinic | 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 |
26 E SUPERIOR ST STE 205 |
| City | DULUTH |
| State | MN |
| Zip Code | 55802-2196 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093794794 | Peter Alan Wodrich | Family Medicine | 26 E Superior St, Ste. 205, Duluth, MN 55802-2124 | 2006-01-11 |
| 1093168866 | Blaire Marie Hysjulien | Marriage & Family Therapist | 26 E Superior St, Suite 315, Duluth, MN 55802-2124 | 2016-07-18 |
| 1568892644 | Casey L Wyman | Counselor | 26 E Superior St, Suite 315, Duluth, MN 55802-2124 | 2013-11-26 |
| 1962769562 | Jenna Lee Clappier | Family Medicine | 26 E Superior St, Ste. 205, Duluth, MN 55802-2124 | 2012-04-19 |
| 1871850479 | Stephen Joseph Clappier | Family Medicine | 26 E Superior St, Ste. 205, Duluth, MN 55802-2124 | 2012-04-19 |
| 1437431871 | Melissa Ann Nervick-thornton | Counselor | 26 E Superior St, Duluth, MN 55802-2124 | 2011-09-12 |
| 1609037183 | Toni Marie Roberts | Physician Assistant | 26 E Superior St, Ste. 205, Duluth, MN 55802-2124 | 2008-06-18 |
| 1275542037 | Rachel Marie Nelson | Family Medicine | 26 E Superior St, Suite 205, Duluth, MN 55802-2124 | 2006-08-07 |
| 1174573208 | Nyasha L.m. Spears | Family Medicine | 26 E Superior St, Ste. 205, Duluth, MN 55802-2124 | 2006-05-11 |
| 1093794760 | Robert Glenn Mcdonald | Family Medicine | 26 E Superior St, Suite 205, Duluth, MN 55802-2124 | 2006-01-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063915239 | Jpw Counseling & Consultation | Social Worker | 302 W Superior St Ste 508, Duluth, MN 55802 | 2018-03-14 |
| 1134664311 | Amp Group, LLC | Counselor | 331 West Superior Street, Duluth, MN 55802 | 2016-12-27 |
| 1982151361 | Tiffany Riester | Counselor | 332 W Superior Street, Suite 300, Duluth, MN 55802 | 2016-09-02 |
| 1730635392 | Karina Krosbakken | Counselor | 332 W. Superior St., Suite 300, Duluth, MN 55802 | 2016-09-01 |
| 1437559051 | Natalie R Zwak | Dietitian, Registered | 26 E Superior St Ste 315, Duluth, MN 55802 | 2014-09-02 |
| 1447679279 | Valerie Lou Shelton | Registered Nurse | 118 E Superior St., Duluth, MN 55802 | 2014-04-09 |
| 1285063115 | Brian Bergstedt | Counselor | 332 West Superior Street, Suite 300, Duluth, MN 55802 | 2013-11-01 |
| 1508135948 | Karen Dee Turner | Counselor | 202 W. Superior Street, Suite 700, Duluth, MN 55802 | 2011-12-14 |
| 1497023410 | Jean Barrie Mcbride | Pharmacist | 1131 East Superior Street, Duluth, MN 55802 | 2011-12-05 |
| 1194092304 | Diane Murphy Winship | Pharmacist | 1331 Superior St, Duluth, MN 55802 | 2011-11-17 |
| Find all providers in zip 55802 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811553084 | Clement Ayanbadejo LLC | Family Medicine | 2282 Meadow Church Rd Ste 200, Duluth, GA 30097-5318 | 2019-05-14 |
| 1902391923 | Young-tae Kim | Family Medicine | 3610 Peachtree Industrial Blvd Ste 100, Duluth, GA 30096-5139 | 2018-06-22 |
| 1659655538 | Primary Care of Atlanta | Family Medicine | 4124 Chattahoochee Trce, Ste 103, Duluth, GA 30097-2147 | 2011-10-10 |
| 1639462997 | James F Conniff | Family Medicine | Duluth Family Medicine Clinic, 330 N Eighth Ave E, Duluth, MN 55805 | 2011-05-19 |
| 1497087126 | St. Luke's Hospital of Duluth | Family Medicine | 6351 E. Superior St., Duluth, MN 55804-2545 | 2010-02-05 |
| 1861729816 | Mark Steven Grimsley | Family Medicine | 1611 Satellite Blvd Ste 3, Duluth, GA 30097 | 2009-11-12 |
| 1154552990 | Clement O Ayanbadejo | Family Medicine | 2282 Meadow Church Rd, Ste 200, Duluth, GA 30097-5318 | 2009-07-28 |
| 1891950457 | Liem Chi Ngo | Family Medicine | 4470 Satellite Blvd, Suite 204, Duluth, GA 30096-8851 | 2008-07-23 |
| 1962663302 | Martin Charles Hinz | Family Medicine | 1150 88th Ave W, Duluth, MN 55808-1505 | 2008-06-18 |
| 1447422506 | Onelio Emilio Perdomo | Family Medicine | 3750 Venture Drive, Suite 130, Duluth, GA 30096-1808 | 2008-03-28 |
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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.