RONDA FARAH (NPI# 1386963536) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386963536 |
| Entity Type | Individual |
| Full Name | RONDA FARAH |
| Credential | M.D. |
| Practice Address |
14500 99th Ave N Maple Grove MN 55369-4730 |
| Practice Telephone | 7638981570 |
| Practice Fax Number | 7638981576 |
| Mailing Telephone | 7638981570 |
| Mailing Fax Number | 7638981576 |
| Enumeration Date | 2010-05-27 |
| Last Update Date | 2014-07-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207N00000X | Dermatology | 40182 | IA | Allopathic & Osteopathic Physicians |
| Y | 207N00000X | Dermatology | 58018 | MN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | MEDICARE PTAN | H400141467 | 01 |
| MN | 1386963536 | 05 |
| Street Address |
14500 99TH AVE N |
| City | MAPLE GROVE |
| State | MN |
| Zip Code | 55369-4730 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649275777 | Jeannette Louise Wilcox | Radiology | 14500 99th Ave N, Maple Grove, MN 55369-4730 | 2005-06-16 |
| 1215487525 | Wendy Blue | Registered Nurse | 14500 99th Ave N, Maple Grove, MN 55369-4730 | 2016-10-11 |
| 1942667209 | Rachel Leigh Lahti | Physician Assistant | 14500 99th Ave N, Maple Grove, MN 55369-4730 | 2016-01-18 |
| 1033585914 | Michaela Monetti | Psychologist | 14500 99th Ave N, Maple Grove, MN 55369-4730 | 2015-08-14 |
| 1922486109 | Charmi Shah | Internal Medicine | 14500 99th Ave N, Maple Grove, MN 55369-4730 | 2015-05-08 |
| 1356748495 | Nitika Ghattaura | Internal Medicine | 14500 99th Ave N, Maple Grove, MN 55369-4730 | 2014-12-03 |
| 1235571191 | Hanaa Tahir | Physician Assistant | 14500 99th Ave N, Maple Grove, MN 55369-4730 | 2013-07-20 |
| 1003255472 | Sarah Nicole Olson Venning | Counselor | 14500 99th Ave N, Maple Grove, MN 55369-4730 | 2013-06-19 |
| 1275970402 | Sarah A Wernimont | Obstetrics & Gynecology | 14500 99th Ave N, Maple Grove, MN 55369-4730 | 2013-05-29 |
| 1346582558 | Bethany Ann Sabol | Obstetrics & Gynecology | 14500 99th Ave N, Maple Grove, MN 55369-4730 | 2013-03-26 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376144188 | Bonnie Rose Theis | Counselor | 24 3rd Ave Ne, Unit B, Osseo, MN 55369 | 2020-11-06 |
| 1356976328 | Kirollos Samir Hanna | Pharmacist | 14500 99th Ave N, Suite 0a030, Maple Grove, MN 55369 | 2020-03-10 |
| 1396395463 | Susan Osborne | Technician | 9240 Orchid Lane, Maple Grove, MN 55369 | 2019-09-19 |
| 1710537196 | Janis Langsdale | Technician | 11070 108 Avenue North, Maple Grove, MN 55369 | 2019-09-17 |
| 1043724552 | Tracey Wahlquist | Speech-Language Pathologist | 11100 86th Ave N, Maple Grove, MN 55369 | 2017-11-20 |
| 1154860005 | Kayla Uptagrafft | Specialist/Technologist | 9555 Upland Lane Norh, Maple Grove, MN 55369 | 2017-02-13 |
| 1750823324 | Jennifer Ranallo | Social Worker | 9600 Upland Ln N Ste 110, Maple Grove, MN 55369 | 2016-11-13 |
| 1558723999 | Debra Grace Boersma | Advanced Practice Midwife | 9825 Hospital Dr#205, Maple Grove, MN 55369 | 2016-03-24 |
| 1396129433 | Maple Grove Smiles Dentistry, PC | Dentist | 12775 Elm Creek Blvd N, Maple Grove, MN 55369 | 2015-07-18 |
| 1558755900 | Krista Newman | Counselor | 24 3rd St Nw, Unit B, Osseo, MN 55369 | 2015-03-24 |
| Find all providers in zip 55369 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821054222 | Heidi G H Cole | Dermatology | 9555 Upland Lane North, Maple Grove, MN 55369 | 2006-04-25 |
| 1164406369 | Jeannie Therese Larson | Dermatology | 9555 Upland Lane N, Maple Grove, MN 55369 | 2005-12-01 |
| 1891152641 | Stephen William Lewellis | Dermatology | 9555 Upland Ln N, Maple Grove, MN 55369 | 2016-01-25 |
| 1386025567 | Carol Philippe | Dermatology | 9555 Upland Ln N, Maple Grove, MN 55369 | 2015-06-14 |
| 1205128592 | Lauren B O'neill | Dermatology | 9555 Upland Ln N, Maple Grove, MN 55369-4485 | 2011-05-05 |
| 1477543957 | Kathleen Maccarthy Demanivel | Dermatology | 14500 99th Ave N, Maple Grove, MN 55369-4478 | 2005-10-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962871608 | Lakes Dermatology, Pa | Dermatology | 14305 Southcross Dr W, Suite 110, Burnsville, MN 55306-7009 | 2015-09-23 |
| 1194133157 | Adam Schmitt | Dermatology | 2 Carlson Pkwy N Ste 240, Plymouth, MN 55447 | 2014-07-22 |
| 1578982773 | Lori Ann Fiessinger | Dermatology | 420 Delaware Street Se, Mmc 98, Minneapolis, MN 55455 | 2014-04-15 |
| 1942629795 | Shane O'neil | Dermatology | 500 Osborne Rd Ne Ste 330, Fridley, MN 55432 | 2014-04-09 |
| 1033537782 | Erin Sellinger | Dermatology | 2 Carlson Pkwy N, Ste 240, Plymouth, MN 55447-4485 | 2014-03-31 |
| 1033555230 | Samuel Blake Ecker | Dermatology | 3655 Plymouth Blvd Ste 110, Minneapolis, MN 55446-3665 | 2013-05-14 |
| 1295078913 | Jessica Jane Newman | Dermatology | 4-240, Phillips-wangensteen Bldg., 516 Delaware Street S.e., Mail Code 98, Minneapolis, MN 55455 | 2013-04-01 |
| 1437416088 | Tiffany Lynn Shih | Dermatology | 401 Phalen Blvd # Ms 41102b, Saint Paul, MN 55130-5302 | 2012-04-20 |
| 1124317383 | Sara Anne Hylwa | Dermatology | 730 South 8th Street, Department of Dermatology, Minneapolis, MN 55415 | 2011-03-28 |
| 1770885360 | Thomas Joseph Kalb | Dermatology | 13420 106th St., Young America, MN 55397-5401 | 2010-12-02 |
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| City | MAPLE GROVE |
| Zip Code | 55369 |
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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.