FERGUS FALLS MEDICAL GROUP, P.A. (NPI# 1376587972) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376587972 |
| Entity Type | Organization |
| Organization Name | FERGUS FALLS MEDICAL GROUP, P.A. |
| Other Organization Name | BATTLE LAKE CLINIC |
| Practice Address |
410 Lake Ave S Battle Lake MN 56515 |
| Mailing Address |
615 S Mill St Fergus Falls MN 56537-2756 |
| Practice Telephone | 2188645283 |
| Practice Fax Number | 2188648452 |
| Mailing Telephone | 2187392221 |
| Mailing Fax Number | 2187395501 |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | JIM WILKUS (CEO) |
| Authorized Official Telephone | 2187392221 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
44 | MN | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | BLC UCARE # | 115098 | 01 |
| MN | BLC MEDICA # | 00-01587 | 01 |
| ND | 13380 | 05 | |
| MN | BLC BCBS # | 62345FE | 01 |
| Other Name | Type Code |
|---|---|
| Battle Lake Clinic | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982649216 | Fergus Falls Medical Group, P.a. | Clinic/Center | 204 5th Street E, Herman, MN 56248-0304 | 2006-06-19 |
| 1750326070 | Fergus Falls Medical Group, P.a. | Clinic/Center | 404 West Broadway, Brown's Valley, MN 56219 | 2006-06-19 |
| 1619915543 | Fergus Falls Medical Group, P.a. | Clinic/Center | 403 12th St N, Wheaton, MN 56296-1070 | 2006-06-03 |
| 1285676031 | Fergus Falls Medical Group, P.a. | Clinic/Center | 615 S Mill St, Fergus Falls, MN 56537-2756 | 2006-06-12 |
| 1134167166 | Fergus Falls Medical Group, P.a. | Clinic/Center | 405 Main St, Ashby, MN 56309-4659 | 2006-06-03 |
| 1730127812 | Fergus Falls Medical Group, P.a. | Family Medicine | 2001 W Lincoln Ave, Suite 56, Fergus Falls, MN 56537-1010 | 2006-06-02 |
| Street Address |
410 LAKE AVE S |
| City | BATTLE LAKE |
| State | MN |
| Zip Code | 56515 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619281177 | Ruth Peterka | Dentist | 412 Lake Avenue North, Battle Lake, MN 56515 | 2010-07-27 |
| 1346435542 | Area Lakes Dental, LLC | Dentist | 412 Lake Avenue South, Battle Lake, MN 56515 | 2007-09-11 |
| 1114125333 | The Evangelical Lutheran Good Samaritan Society | Assisted Living Facility | 605 Lake Ave North, Battle Lake, MN 56515 | 2007-07-10 |
| 1336223577 | Traill Alan Vosberg | Physical Therapist | 105 Glenhaven Drive, Battle Lake, MN 56515 | 2006-10-24 |
| 1326055468 | Chase Chiropractic | Chiropractor | 104 Memory Lane, Battle Lake, MN 56515 | 2006-08-02 |
| 1720081359 | Todd S Smith | Dentist | 412 Lake Ave. S., Battle Lake, MN 56515 | 2005-05-27 |
| 1235501180 | Chase Family Health | Nurse Practitioner | 104 Memory Lane, Battle Lake, MN 56515 | 2015-10-30 |
| 1487661203 | John Gerald Chase | Chiropractor | 104 Memory Lane, Battle Lake, MN 56515 | 2006-08-02 |
| 1366657033 | Village Apothecary Inc | Pharmacist | 113 Lake Ave North, Battle Lake, MN 56515-0538 | 2007-05-14 |
| 1902980238 | Amy Louise Cory | Pharmacist | 113 Lake Ave N, Battle Lake, MN 56515-0538 | 2006-10-24 |
| Find all providers in zip 56515 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
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| 1053952606 | Fairview Express Care | Clinic/Center | 2512 6th Street, Suite F105, Minneapolis, MN 55454-1401 | 2019-10-04 |
| 1730731464 | St Marys Regional Health Center | Clinic/Center | 1103 1st St E, Park Rapids, MN 56470 | 2019-07-12 |
| 1003478892 | The Duluth Clinic Ltd | Clinic/Center | 4289 Ugstad Rd, Hermantown, MN 55811-3615 | 2019-07-02 |
| 1073005856 | Arbor Integrative Behavioral Health | Clinic/Center | 1000 E 1st St Ste 105, Duluth, MN 55805-2297 | 2018-06-06 |
| 1689161077 | Chs Tennessee Medical P C | Clinic/Center | 701 Brooks Ave S, Thief River Falls, MN 56701-2757 | 2018-04-20 |
| 1427557867 | Gillette Children's Specialty Healthcare | Clinic/Center | 505 Paul Bunyan Dr Nw, Bemidji, MN 56601-2400 | 2018-02-11 |
| 1992224331 | Orthopedic & Sports Physical Therapy, Inc. | Clinic/Center | 322 N Tower Rd, Fergus Falls, MN 56537-1015 | 2017-09-18 |
| 1003339789 | Centracare Clinic | Clinic/Center | 2025 Stearns Way Ste 114, Saint Cloud, MN 56303 | 2017-07-25 |
| Find all providers with the same taxonomy | ||||
| City | BATTLE LAKE |
| Zip Code | 56515 |
Please comment or provide details below to improve the information on FERGUS FALLS MEDICAL GROUP, P.A..
| 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.