DERMATOLOGY PROFESSIONALS, PA (NPI# 1356714182) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356714182 |
| Entity Type | Organization |
| Organization Name | DERMATOLOGY PROFESSIONALS, PA |
| Practice Address |
2300 24th St Nw Suite 110 Bemidji MN 56601-6379 |
| Mailing Address |
13359 Isle Dr Suite 3 Baxter MN 56425-2222 |
| Practice Telephone | 2184547546 |
| Mailing Telephone | 2184547546 |
| Enumeration Date | 2015-11-02 |
| Last Update Date | 2015-11-02 |
| Authorized Official Name | ANGIE KUGEL (ADMINISTRATOR) |
| Authorized Official Telephone | 2184543065 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | 1699 | MN | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 355427000 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720269426 | Dermatology Professionals, Pa | Clinic/Center | 13359 Isle Dr, Ste 3, Baxter, MN 56425 | 2007-11-21 |
| Street Address |
2300 24TH ST NW SUITE 110 |
| City | BEMIDJI |
| State | MN |
| Zip Code | 56601-6379 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780043240 | Heather M Stone | Physical Therapist | 2300 24th St Nw, Suite 101, Bemidji, MN 56601-6379 | 2016-02-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336772425 | Northern Minnesota Addiction Wellness Center | Substance Abuse Rehabilitation Facility | 4851 Stacy Ann Dr Nw, Bemidji, MN 56601 | 2020-02-17 |
| 1366093841 | Vickie Lynn Matthews | Technician | 1018 Miles Ave Se, Bemidji, MN 56601 | 2019-09-25 |
| 1518443530 | Lindsey Marie Whiting | Registered Nurse | 1300 Anne St, Bemidji, MN 56601 | 2018-07-12 |
| 1801257662 | Meghan Zigrida Paquette | Registered Nurse | 6055 161st Street Nw, Cass Lake, MN 56601 | 2016-03-08 |
| 1144686106 | Northwest Indian Oic | Home Health | 1819 Bemidji Ave N Ste 1, Bemidji, MN 56601 | 2016-01-06 |
| 1831560424 | Laura Hansen, Msw, Licsw Counseling Services, Inc. | Social Worker | 403 4th Street Ne, Suite 110, Bemidji, MN 56601 | 2015-10-08 |
| 1679949028 | Grand St. Paul Cvs LLC | Durable Medical Equipment & Medical Supplies | 2312 Bemidji Ave North, Bemidji, MN 56601 | 2015-08-19 |
| 1255717617 | Mary S. Salter, Md Psc | Internal Medicine | 514 Beltrami Ave Nw Suite 102, Bemidji, MN 56601 | 2015-08-07 |
| 1225420615 | Cristin Evans | Counselor | 403 4th Street, Suite 300, Bemidji, MN 56601 | 2015-02-23 |
| 1619367919 | Angela Krom Fournier | Psychologist | 16150 Golden Eagle Court Nw, Eagle Vista Equine Center Inc., Bemidji, MN 56601 | 2015-01-26 |
| Find all providers in zip 56601 | ||||
| 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 |
|---|---|---|---|---|
| 1619269545 | Sanford Clinic North | Clinic/Center | 3807 Greenleaf Ave Nw, Bemidji, MN 56601-5817 | 2011-05-11 |
| 1083881452 | Bemidji State University | Clinic/Center | 1500 Birchmont Dr Ne # 30, Bemidji, MN 56601-2600 | 2008-05-14 |
| 1316991334 | North Country Medical Clinic | Clinic/Center | 619 5th St Nw, Bemidji, MN 56601-2914 | 2006-05-22 |
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|---|---|---|---|---|
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| 1811513310 | Prescribed By LLC | Clinic/Center | 701 Washington Ave N Ste 111-321, Minneapolis, MN 55401-2822 | 2020-06-19 |
| 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 |
| Find all providers with the same taxonomy | ||||
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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.