KEITH BRUCE MCCOLLISTER (NPI# 1427292796) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427292796 |
| Entity Type | Individual |
| Full Name | KEITH BRUCE MCCOLLISTER |
| Credential | M.D. |
| Practice Address |
166 4th St E Saint Paul MN 55101-1421 |
| Practice Telephone | 6512922000 |
| Enumeration Date | 2009-04-29 |
| Last Update Date | 2018-11-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085N0700X |
Radiology Specialization: Neuroradiology |
10770 | SD | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 1427292796 | 05 |
| Street Address |
166 4TH ST E |
| City | SAINT PAUL |
| State | MN |
| Zip Code | 55101-1421 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558367789 | Richard N. Aizpuru | Radiology | 166 4th St E, Saint Paul, MN 55101-1421 | 2005-06-22 |
| 1982115754 | Erin Kaslow | Social Worker | 166 4th St E, Saint Paul, MN 55101-1421 | 2017-10-19 |
| 1518477454 | Sarah Jean Boehne | Social Worker | 166 4th St E, Saint Paul, MN 55101-1421 | 2017-10-05 |
| 1861934788 | South Metro Human Services-act Purple | Case Management | 166 4th St E, Suite 200, Saint Paul, MN 55101-1421 | 2016-11-09 |
| 1952843864 | South Metro Human Services-act Blue | Case Management | 166 4th St E, Suite 200, Saint Paul, MN 55101-1421 | 2016-11-09 |
| 1023560257 | Cheryl Bertsch | Pharmacist | 166 4th St E, Saint Paul, MN 55101-1421 | 2016-11-04 |
| 1912365669 | Tracy Jost | Nurse Practitioner | 166 4th St E, Saint Paul, MN 55101-1421 | 2016-02-09 |
| 1255708780 | United Family Practice Health Center | Family Medicine | 166 4th St E, Saint Paul, MN 55101-1421 | 2015-09-01 |
| 1952778656 | Laura Lynett | Counselor | 166 4th St E, Saint Paul, MN 55101-1421 | 2015-08-28 |
| 1558785311 | Megan Elgethun | Radiology | 166 4th St E, Saint Paul, MN 55101-1421 | 2014-02-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508480427 | El Solutions LLC | Clinic/Center | 445 Minnesota St., Ste. 1500 12, St. Paul, MN 55101 | 2020-06-05 |
| 1689211443 | Siripa Min | Nurse Anesthetist, Certified Registered | 640 Jackson Street Mail Stop 11503, St. Paul, MN 55101 | 2019-11-28 |
| 1922590488 | Diane Mcleod | Physician Assistant | Healthpartners Regions Specialty Clinics, 640 Jackson St - Mail Stop 11109e, Saint Paul, MN 55101 | 2018-05-31 |
| 1699284919 | Eric Mcgillis | Emergency Medicine | Regions Hospital - Emergency Medicine, 11102f, 640 Jackson St, St Paul, MN 55101 | 2017-09-29 |
| 1073051751 | Hannah Elizabeth Rosenthal Danielson | Physician Assistant | 640 Jackson St # Ms 11102m, Saint Paul, MN 55101 | 2017-02-02 |
| 1992182323 | Theresa Annette Cashdollar-powell | Social Worker | 640 Jackson, St Paul, MN 55101 | 2015-05-06 |
| 1770986101 | Margaret Augusta Cutter | Physician Assistant | 200 Univeristy Ave E, Saint Paul, MN 55101 | 2014-09-30 |
| 1851641419 | Lisa Rae Caturia | Occupational Therapy Assistant | 640 Jackson St, 8th Floor, St Paul, MN 55101 | 2012-09-11 |
| 1558619478 | Rph On The Go | Community/Behavioral Health | 172 E 6th Street, 704, Saint Paul, MN 55101 | 2012-08-27 |
| 1184994212 | Duyen Truong | Pharmacist | 604 Jackson Street, St. Paul, MN 55101 | 2012-01-05 |
| Find all providers in zip 55101 | ||||
| Taxonomy Code | 2085N0700X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Neuroradiology |
| A radiologist who diagnoses and treats diseases utilizing imaging procedures as they relate to the brain, spine and spinal cord, head, neck and organs of special sense in adults and children. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750607248 | Matthew Adam Rischall | Radiology | 250 Thompson St, Saint Paul, MN 55102-2370 | 2010-04-09 |
| 1376660647 | Radha Inampudi | Radiology | 166 4th St E, Saint Paul, MN 55101-1421 | 2007-03-23 |
| 1700930344 | Scott Edward Hunter | Radiology | 166 4th St E, Saint Paul, MN 55101-1400 | 2007-01-22 |
| 1619905924 | Jeffrey Rex Brace | Radiology | 250 Thompson St, Saint Paul, MN 55102-2370 | 2006-06-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558770297 | Christopher Stevens | Radiology | 1728 Quarry Ridge Pl Nw Apt 115, Rochester, MN 55901-0819 | 2014-08-07 |
| 1902162985 | Mark Daniel Folkertsma | Radiology | 2021 6th St Se Ste 300, Minneapolis, MN 55455-3007 | 2012-04-04 |
| 1235519992 | Alex Woehlke | Radiology | 200 First Street Sw, Rochester, MN 55905-0001 | 2015-06-08 |
| 1134508054 | Mehmet Gencturk | Radiology | 909 Fulton St Se, Minneapolis, MN 55455-4800 | 2015-05-26 |
| 1376955864 | Sara Boyd | Radiology | 200 1st St Sw, Rochester, MN 55905-5919 | 2014-06-02 |
| 1285045534 | Duncan Ben Davidson | Radiology | 7505 Metro Blvd Ste 400, Edina, MN 55439 | 2014-05-08 |
| 1609294867 | Sergey V Kulikov | Radiology | 2800 Campus Dr Ste 20, Plymouth, MN 55441-2669 | 2014-04-03 |
| 1538504303 | Huseyin Gurkan Tore | Radiology | 909 Fulton St Se, Minneapolis, MN 55455-4800 | 2013-05-06 |
| 1134462963 | John Benson | Radiology | 200 1st St Sw, Rochester, MN 55905 | 2013-03-29 |
| 1932469673 | Alexander Zachary Copelan | Radiology | 7505 Metro Blvd Ste 400, Edina, MN 55439-3010 | 2012-05-28 |
| Find all providers with the same taxonomy | ||||
| City | SAINT PAUL |
| Zip Code | 55101 |
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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.