SCOTT KLETTKE (NPI# 1487965109) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487965109 |
| Entity Type | Individual |
| Full Name | SCOTT KLETTKE |
| Credential | M.D. |
| Practice Address |
1990 Connecticut Ave S Sartell MN 56377-2554 |
| Practice Telephone | 3202577787 |
| Practice Fax Number | 3202575596 |
| Mailing Telephone | 3202577787 |
| Mailing Fax Number | 3202575596 |
| Enumeration Date | 2010-06-28 |
| Last Update Date | 2016-10-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
60481 | MN | Allopathic & Osteopathic Physicians |
| Street Address |
1990 CONNECTICUT AVE S |
| City | SARTELL |
| State | MN |
| Zip Code | 56377-2554 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306846076 | Jody Allison Bolton Smith | Radiology | 1990 Connecticut Ave S, Sartell, MN 56377-2554 | 2005-07-26 |
| 1457881021 | Angela Marie Schuster | Physician Assistant | 1990 Connecticut Ave S, Sartell, MN 56377-2554 | 2017-06-15 |
| 1104192541 | James Dickinson | Radiology | 1990 Connecticut Ave S, Sartell, MN 56377-2554 | 2012-03-30 |
| 1467761130 | Nathan B Danielson | Radiology | 1990 Connecticut Ave S, Sartell, MN 56377-2554 | 2010-09-29 |
| 1487819751 | Francis X. Kigozi | Radiology | 1990 Connecticut Ave S, Sartell, MN 56377-2554 | 2008-07-25 |
| 1598925539 | Darrin John Spoden | Radiology | 1990 Connecticut Ave S, Sartell, MN 56377-2554 | 2008-06-12 |
| 1710150321 | Leslie Hartman | Radiology | 1990 Connecticut Ave S, Sartell, MN 56377-2554 | 2008-04-04 |
| 1972782951 | Chadd James Mcmahon | Radiology | 1990 Connecticut Ave S, Sartell, MN 56377-2554 | 2007-10-26 |
| 1881890549 | Nicole R Mercer Bolton | Radiology | 1990 Connecticut Ave S, Sartell, MN 56377-2554 | 2007-06-21 |
| 1811105182 | Mohammad Asif Dogar | Radiology | 1990 Connecticut Ave S, Sartell, MN 56377-2554 | 2007-05-19 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235783515 | Chae Norman | Massage Therapist | 303 4th Ave S, Suite C, Sartell, MN 56377 | 2019-07-25 |
| 1497317259 | Stephanie Maria Schaefer | Behavioral Analyst | 1133 Mockingbird Loop, Sartell, MN 56377 | 2019-07-02 |
| 1538722848 | Madison Toughill | Behavior Technician | 205 14th Ave E, Sartell, MN 56377 | 2019-04-22 |
| 1902388671 | Julie Ann Helms | Counselor | 101 Dehler Dr., Sartell, MN 56377 | 2018-08-30 |
| 1104337617 | Louis Chester Winskowski IIi | Orthotist | 50 14th Ave E Suite 114, Sartell, MN 56377 | 2017-10-24 |
| 1962958611 | Centracare Clinic | Exclusive Provider Organization | 166 19th Street S, Suite 202, Sartell, MN 56377 | 2016-08-31 |
| 1295197846 | Mindful Healing & Training | Counselor | 1417 15th Street South, Sartell, MN 56377 | 2016-03-23 |
| 1710342894 | Saint Cloud Hospital St. Benedict's Senior Community | Skilled Nursing Facility | 990 19th St. S., Sartell, MN 56377 | 2015-12-16 |
| 1932452661 | David Peter Pogatchnik | Pharmacist | 2251 Connecticut Ave. South, Health Partners Central Minnesota Clinics (pharmacy), Sartell, MN 56377 | 2012-10-18 |
| 1669759866 | Lakewood Health System | Clinic/Center | 161 19th St S Ste 106, Sartell, MN 56377 | 2011-11-16 |
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| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| 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 |
|---|---|---|---|---|
| 1356458475 | Mobile Imaging Services, LLC | Radiology | 2000 Abbott Nw Ct, Ste 115, Sartell, MN 56377 | 2006-08-24 |
| 1700831690 | Karla Gay Myhra-bloom | Radiology | 709 17th St N, Sartell, MN 56377 | 2006-05-23 |
| 1649258526 | Michael James Cumming | Radiology | 1990 Connecticut Ave S Ste 100, Sartell, MN 56377-2554 | 2006-01-03 |
| 1306846076 | Jody Allison Bolton Smith | Radiology | 1990 Connecticut Ave S, Sartell, MN 56377-2554 | 2005-07-26 |
| 1780684639 | John Gregory Dalle | Radiology | 166 19th Street South, Suite 100, Sartell, MN 56377-2154 | 2005-07-21 |
| 1023351533 | Shannon Nord | Radiology | 1990 Connecticut Ave S Ste 100, Sartell, MN 56377-2554 | 2013-04-03 |
| 1104192541 | James Dickinson | Radiology | 1990 Connecticut Ave S, Sartell, MN 56377-2554 | 2012-03-30 |
| 1598085268 | Britton Joseph Carter | Radiology | 166 19th Street South, Suite 100, Sartell, MN 56377-2154 | 2010-06-04 |
| 1487819751 | Francis X. Kigozi | Radiology | 1990 Connecticut Ave S, Sartell, MN 56377-2554 | 2008-07-25 |
| 1457514341 | Mats Lars Liden | Radiology | 166 19th Street South, Suite 100, Sartell, MN 56377-2154 | 2008-07-09 |
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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.