ACNE, SKIN DISEASE & LEG VEIN CLINIC, P.A. (NPI# 1417163189) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417163189 |
| Entity Type | Organization |
| Organization Name | ACNE, SKIN DISEASE & LEG VEIN CLINIC, P.A. |
| Practice Address |
3960 Coon Rapids Blvd Nw Suite 116 Coon Rapids MN 55433-2569 |
| Practice Telephone | 7634278113 |
| Practice Fax Number | 7634278131 |
| Mailing Telephone | 7634278113 |
| Mailing Fax Number | 7634278131 |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2008-08-07 |
| Authorized Official Name | DR. THEODORE JOSEPH BUSELMEIER (PRESIDENT) |
| Authorized Official Telephone | 7634278113 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians |
| Street Address |
3960 COON RAPIDS BLVD NW SUITE 116 |
| City | COON RAPIDS |
| State | MN |
| Zip Code | 55433-2569 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740275833 | Byron A Teska | Ophthalmology | 3960 Coon Rapids Blvd Nw, Suite 304, Coon Rapids, MN 55433-2569 | 2005-09-14 |
| 1689068462 | Group Health Plan, Inc. | Clinic/Center | 3960 Coon Rapids Blvd Nw, Suite 311, Coon Rapids, MN 55433 | 2015-03-19 |
| 1770829939 | Handi Medical Supply, Inc. | Durable Medical Equipment & Medical Supplies | 3960 Coon Rapids Blvd Nw, Ste #102, Coon Rapids, MN 55433-2521 | 2012-12-17 |
| 1245510700 | Lesley Rae Kurowski | Nurse Practitioner | 3960 Coon Rapids Blvd Nw, Suite 311, Coon Rapids, MN 55433-2569 | 2011-08-27 |
| 1629387303 | Minnesota Oncology Hematology Pa | Clinic/Center | 3960 Coon Rapids Blvd Nw, # 311, Coon Rapids, MN 55433-2569 | 2010-09-29 |
| 1558696526 | Kimberly F Laxmana | Nurse Practitioner | 3960 Coon Rapids Blvd Nw, Suite 101, Coon Rapids, MN 55433-2569 | 2009-10-08 |
| 1326276627 | Katherine Wolf Gurchak | Obstetrics & Gynecology | 3960 Coon Rapids Blvd Nw, Suite 101, Coon Rapids, MN 55433-2569 | 2009-06-24 |
| 1679715601 | Patricia Ann Harper | Obstetrics & Gynecology | 3960 Coon Rapids Blvd Nw, Suite 101, Coon Rapids, MN 55433-2569 | 2009-04-06 |
| 1447409834 | Minnesota Oncology Hematology, Pa | Obstetrics & Gynecology | 3960 Coon Rapids Blvd Nw, Suite 101, Coon Rapids, MN 55433-2569 | 2008-09-10 |
| 1528256062 | Carmen J Schroeder | Nurse Practitioner | 3960 Coon Rapids Blvd Nw, Suite 311, Coon Rapids, MN 55433-2569 | 2007-10-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770134793 | Shelley Karee Peterson | Technician | 10311 Bittersweet St Nw, Coon Rapids, MN 55433 | 2019-09-20 |
| 1578122057 | Courtney Gau | Behavior Technician | Fraser Coon Rapids, 9120 Springbrook Dr. Nw, Coon Rapids, MN 55433 | 2019-06-10 |
| 1992275606 | Maliki Fofee Kamara | Licensed Practical Nurse | 2451 109th Ave Nw Apt. 1, Coon Rapids, MN 55433 | 2018-11-26 |
| 1992284541 | Sarah Vennes | Massage Therapist | 6400 Flying Cloud Dr, Suite 240, Eden Prairie, MN 55433 | 2018-08-13 |
| 1538646609 | Paige Prince | Behavior Technician | Fraser Coon Rapids, 9120 Springbrook Drive Nw, Coon Rapids, MN 55433 | 2018-07-23 |
| 1154828242 | Karin Lea Englund | Dentist | 9145 Springbrook Dr Nw Ste 100, Coon Rapids, MN 55433 | 2018-04-06 |
| 1235642513 | Vista Family Eye Care LLC | Optometrist | 9920 Foley Blvd Nw Ste 120, Coon Rapids, MN 55433 | 2017-11-09 |
| 1538697818 | Mohammed Nmn Ahmed | Internal Medicine | 9055 Spring Brook Drive, Allina Coon Rapids Clinic 9055, Coon Rapids, MN 55433 | 2017-05-31 |
| 1639531353 | Journi LLC | Nurse Practitioner | 277 Coon Rapids Blvd Suite 308, Coon Rapids, MN 55433 | 2016-03-22 |
| 1821457722 | Honorine Boyce | Licensed Practical Nurse | 2743 111th Ave. Nw, Coon Rapids, MN 55433 | 2016-02-19 |
| Find all providers in zip 55433 | ||||
| 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 |
|---|---|---|---|---|
| 1528171428 | Theodore Joseph Buselmeier | Dermatology | 3960 Coon Rapids Blvd Nw, Suite 116, Coon Rapids, MN 55433-2569 | 2006-08-16 |
| 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 |
| Find all providers with the same taxonomy | ||||
| City | COON RAPIDS |
| Zip Code | 55433 |
Please comment or provide details below to improve the information on ACNE, SKIN DISEASE & LEG VEIN CLINIC, 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.