RANDALL A BOSTROM


Address: 331 Highway 65 S, Mora, MN 55051-1899
Phone: 3206791313

RANDALL A BOSTROM (NPI# 1396705083) 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) 1396705083
Entity Type Individual
Full Name RANDALL A BOSTROM
Credential MD
Practice Address 331 Highway 65 S
Mora
MN 55051-1899
Mailing Address Po Box 43
Mr 10809
Minneapolis
MN 55440-0043
Practice Telephone 3206791313
Practice Fax Number 3202253141
Mailing Telephone 6122624813
Mailing Fax Number 6122624194
Enumeration Date 2006-03-25
Last Update Date 2007-07-08
Gender Code M
Is Sole Proprietor X

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207Q00000X Family Medicine 30066 MN Allopathic & Osteopathic Physicians

Office Location

Street Address 331 HIGHWAY 65 S
City MORA
State MN
Zip Code 55051-1899

Providers in the same location

NPI Name Taxonomy Address Enumeration
1467757062 Urology Associates, Ltd. Urology 331 Highway 65 S, Mora, MN 55051-1899 2011-01-13
1912130238 Janet Lynn Wilkinson Registered Nurse 331 Highway 65 S, Mora, MN 55051-1899 2009-09-03
1255395406 Peter J Donner Family Medicine 331 Highway 65 S, Mora, MN 55051-1899 2006-04-14
1922062637 Terry A Johnson Family Medicine 331 Highway 65 S, Mora, MN 55051-1899 2006-04-12
1083677041 Karen K Rasmusson Nurse Practitioner 331 Highway 65 S, Mora, MN 55051-1899 2006-04-10
1346202926 Barbara Lou Ennis Nurse Practitioner 331 Highway 65 S, Mora, MN 55051-1899 2006-04-06
1457313124 Jack D Schwinghamer Family Medicine 331 Highway 65 S, Mora, MN 55051-1899 2006-04-06
1881656866 Amy Marie Mcdaniel Physician Assistant 331 Highway 65 S, Mora, MN 55051-1899 2006-04-05
1922068329 Larry J. Brettingen Family Medicine 331 Highway 65 S, Mora, MN 55051-1899 2006-03-28
1053371740 Renee L Coleman Physician Assistant 331 Highway 65 S, Mora, MN 55051-1899 2006-03-25
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1801407085 Anna Insley Pharmacist 301 Mn-65, Inpatient Pharmacy, Mora, MN 55051 2020-08-12
1609286368 Love The Journey Inc Clinic/Center 23 Pine St N, Mora, MN 55051 2014-05-04
1386981637 Urology Associates, Ltd. Urology 244 7th Street North, Mora, MN 55051 2013-01-07
1710236138 Rebecca Suzanne Autio Nurse Practitioner 301 Highway 65 South, Mora, MN 55051 2012-08-30
1154639128 Augustana Senior Development II Assisted Living Facility 170 Valhalla Circle, Mora, MN 55051 2010-09-23
1306064423 Matthew Gordon Allen Family Medicine 331 South Highway 65, Mora, MN 55051 2007-04-23
1942359278 Ralph Dale Swenson Dentist 620 S Union, Mora, MN 55051 2007-01-09
1376620013 Mora Chiropractic Clinic P.C. Chiropractor 114 W Maple Ave, Mora, MN 55051 2006-11-01
1629181094 Janice Lea Fleming Internal Medicine 301 S Hwy 65, Kanabee Hospital, Mora, MN 55051 2006-08-17
1467407502 James Matthew Williams Dentist 620 S Union St, Mora, MN 55051 2006-05-24
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Taxonomy Information

Taxonomy Code 207Q00000X
Grouping Allopathic & Osteopathic Physicians
Classification Family Medicine

Taxonomy Definition

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.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1306064423 Matthew Gordon Allen Family Medicine 331 South Highway 65, Mora, MN 55051 2007-04-23
1235129743 Matthew D Schultz Family Medicine 301 S. Hwy 65, Mora, MN 55051 2005-10-26
1467772707 Ryan Jon Gaalswyk Family Medicine 301 Highway 65 S, Firstlight Health System, Mora, MN 55051-1899 2010-06-09
1821315847 Kathleen Mary Kroschel Family Medicine 301 Highway 65 S, Mora, MN 55051-1899 2010-04-30
1194042119 Ryan Richard Kroschel Family Medicine 301 Highway 65 S, Mora, MN 55051-1899 2010-04-30
1285868190 Ingrid Bwahama Kaijage Family Medicine 301 Highway 65 S, Firstlight Health System, Mora, MN 55051-1899 2009-05-06
1437340437 Danielle Marie Bergman Family Medicine 301 Highway 65 S, Mora, MN 55051-1899 2007-08-05
1881601557 Donald A Dahlen Family Medicine 301 Highway 65 S, Mora, MN 55051-1899 2006-08-02
1255395406 Peter J Donner Family Medicine 331 Highway 65 S, Mora, MN 55051-1899 2006-04-14
1922062637 Terry A Johnson Family Medicine 331 Highway 65 S, Mora, MN 55051-1899 2006-04-12
Find all providers in MORA

Competitor

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City MORA
Zip Code 55051

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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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