JACOB BOTTELBERGHE


Address: 300 S Bruce St, Marshall, MN 56258-1934
Phone: 5075379165

JACOB BOTTELBERGHE (NPI# 1346894748) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1346894748
Entity Type Individual
Full Name JACOB BOTTELBERGHE
Practice Address 300 S Bruce St
Marshall
MN 56258-1934
Mailing Address 1107 300th St
Minneota
MN 56264-1103
Practice Telephone 5075379165
Enumeration Date 2019-07-25
Last Update Date 2019-07-25
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363A00000X Physician Assistant Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 300 S BRUCE ST
City MARSHALL
State MN
Zip Code 56258-1934

Providers in the same location

NPI Name Taxonomy Address Enumeration
1922003409 Alain Desy Orthopaedic Surgery 300 S Bruce St, Marshall, MN 56258-1934 2005-06-20
1336750702 Neil Thomas Eichten Speech-Language Pathologist 300 S Bruce St, Marshall, MN 56258-1934 2020-08-11
1427669894 Victoria Ann Botten Speech-Language Pathologist 300 S Bruce St, Marshall, MN 56258-1934 2020-08-11
1811506694 Kendall Drew Hines Physical Therapist 300 S Bruce St, Marshall, MN 56258-1934 2020-07-28
1053934877 Karen Marie Kersting Physical Therapist 300 S Bruce St, Marshall, MN 56258-1934 2020-05-27
1306474747 Ramy Vandendriessche Physical Therapist 300 S Bruce St, Marshall, MN 56258-1934 2020-03-31
1114576535 Analisa Kay Buysse Pharmacist 300 S Bruce St, Marshall, MN 56258-1934 2019-09-09
1598224321 Hannah Sue Reski Physician Assistant 300 S Bruce St, Marshall, MN 56258-1934 2019-03-19
1245709443 Amy Marie Meyeraan-rowe Nurse Practitioner 300 S Bruce St, Marshall, MN 56258-1934 2018-11-16
1831672492 Nathaniel Erik Thomsen Physical Medicine & Rehabilitation 300 S Bruce St, Marshall, MN 56258-1934 2018-09-10
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1285140012 Action Manufacturing Inc Durable Medical Equipment & Medical Supplies 1105 Lake Road, Marshall, MN 56258 2017-12-15
1124579123 Themarshrx Durable Medical Equipment & Medical Supplies 600 Sherman Ave, Marshall, MN 56258 2016-10-14
1780020370 Heritage Pointe Senio Assisted Living Facility 207 N 4th Street, Marshall, MI 56258 2013-05-22
1528351178 Lori Anne Lynner Family Medicine 3160 Us Hwy 59, Marshall, MN 56258 2011-05-16
1912148545 Tami J Behnke Counselor 1418 State Street, Campus Religious Center, Marshall, MN 56258 2009-03-11
1073768396 Sharyce Marie Audiology Inc Audiologist 1424 East College Drive, Suite 200, Marshall, MN 56258 2008-12-01
1497976625 Erica Anne Jost Specialist/Technologist 1501 State Street, Marshall, MN 56258 2007-05-02
1265597470 Nancy Louise Hemmingson Optometrist 300 S Bruce Street, Avera Marshall Southwest Ophthalmology, Marshall, MN 56258 2006-12-27
1407928187 Midwest Vision Centers Inc Technician/Technologist 1113 E College Drive, Marshall, MN 56258 2006-11-15
1306918354 Paul Joseph Puetz Chiropractor 111 Jewett St, Marshall, MN 56258 2006-11-14
Find all providers in zip 56258

Taxonomy Information

Taxonomy Code 363A00000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant

Taxonomy Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1659656858 Kelly Alicia Hunt Moeller Physician Assistant 1806 E End Blvd N Ste 1300, Marshall, TX 75670-0734 2011-10-19
1841440872 Erin N Grabowski Physician Assistant Marshall Medical Associates, 1174 W. Michigan Ave, Marshall, MI 49068 2008-09-26
1295825925 Hope Marie Howard Physician Assistant 720 Old Us Hwy 27 North, Marshall, MI 49068-9609 2006-10-13
1720018930 George C Noel Physician Assistant 614 S Grove St, Suite A, Marshall, TX 75670-5219 2006-07-04
1982630828 Timothy L Larson Physician Assistant 1401 Nwakama St, Marshall, MN 56258-5529 2006-06-23
1366490005 Tara Lyn Montgomery Physician Assistant 215 E Mansion St Ste 2d, Marshall, MI 49068-1167 2006-05-05
1558343681 Randall Curtis Lane Physician Assistant 811 S. Washington Street, Marshall, TX 75670 2005-11-15
1326049438 Terrance D. Venden Physician Assistant 815 S Washington Ave, Suite 100, Marshall, TX 75670-5369 2005-08-10
1861498768 Ken Yazzie Chambellan Physician Assistant 811 S Washington Ave, Marshall, TX 75670 2005-06-24
1598224321 Hannah Sue Reski Physician Assistant 300 S Bruce St, Marshall, MN 56258-1934 2019-03-19
Find all providers in MARSHALL

Competitor

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City MARSHALL
Zip Code 56258

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Dataset Information

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.

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