UNIVERISTY OF MINNESOTA DULUTH (NPI# 1497157168) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497157168 |
| Entity Type | Organization |
| Organization Name | UNIVERISTY OF MINNESOTA DULUTH |
| Other Organization Name | UMD SPORTS MEDICINE |
| Practice Address |
1216 Ordean Ct Duluth MN 55812-3032 |
| Mailing Address |
5050 Spring Valley Rd Dallas TX 75244-3995 |
| Practice Telephone | 2187268709 |
| Mailing Telephone | 8005559073 |
| Mailing Fax Number | 9723673452 |
| Enumeration Date | 2014-09-24 |
| Last Update Date | 2014-09-24 |
| Authorized Official Name | JOSH BERLO (ASST ATH DIR FOR SPORTS MEDICINE) |
| Authorized Official Telephone | 2187268637 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QS0010X |
Family Medicine Specialization: Sports Medicine |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| UMD Sports Medicine | Doing Business As Name - Organization |
| Street Address |
1216 ORDEAN CT |
| City | DULUTH |
| State | MN |
| Zip Code | 55812-3032 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962770032 | Susan Britton Hoppe | Specialist/Technologist | 1216 Ordean Ct, 170 Sports and Health Center, Duluth, MN 55812-3032 | 2011-12-05 |
| 1073912895 | Jacqueline Phillips | Specialist/Technologist | 1216 Ordean Ct, 170 Sports & Health Center, Duluth, MN 55812-3032 | 2014-08-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942743950 | Thomas Anthony Olson | Specialist/Technologist | 1049 Ordean Court, 170 Sports & Health Center, Duluth, MN 55812 | 2016-11-22 |
| 1922457183 | Zen Eye Care Pllc | Optometrist | 2106 London Road, Duluth, MN 55812 | 2016-06-08 |
| 1295134088 | Charla Buxbaum | Specialist/Technologist | 1216 Ordean Ct. Sphc 170, University of Minnesota Duluth, Duluth, MN 55812 | 2014-08-18 |
| 1346473998 | Patricia A Trachte | Nurse Practitioner | 107 Ksc, Umd Quick Care, Duluth, MN 55812 | 2009-08-31 |
| 1003088543 | Arrowhead House Inc | Community Based Residential Treatment Facility, Mental Illness | 16 South 18th Avenue East, Duluth, MN 55812 | 2008-03-25 |
| 1073689295 | Nicolle Marie Nicklas | Nurse Anesthetist, Certified Registered | 219 Garden St., Duluth, MN 55812 | 2006-11-28 |
| 1346328762 | Timothy Patrick Stratton | Pharmacist | 386a Kirby Plaza, 1208 Kirby Drive, Duluth, MN 55812 | 2006-11-02 |
| 1316960701 | Questar Duluth, Inc | Specialist | 1527 London Road, Duluth, MN 55812 | 2006-07-26 |
| 1063401297 | Clinton T Moen | Specialist | 2711 E 5th St, Duluth, MN 55812 | 2005-10-20 |
| 1124016563 | Christine Aas-larson | Nurse Practitioner | 1502 London Road, Suite 102, Duluth, MN 55812 | 2005-10-10 |
| Find all providers in zip 55812 | ||||
| Taxonomy Code | 207QS0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Sports Medicine |
| A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Family Medicine, 2007. http://www.theabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://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 Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366886053 | Luke David Widstrom | Family Medicine | 400 East Third Street, Essentia Health Duluth Clinic, Duluth, MN 55805-1951 | 2013-04-24 |
| 1942567086 | Carl Peter Rasmussen | Family Medicine | 1400 Woodland Ave, Duluth, MN 55803 | 2012-04-13 |
| 1154498848 | Stephen Curtis Harrington | Family Medicine | 400 E 3rd St, Duluth, MN 55805-1951 | 2006-11-29 |
| 1750465985 | Benjamin David Nelson | Family Medicine | 400 East 3rd Street, Duluth, MN 55805 | 2006-10-24 |
| 1619996832 | Kenji Sudoh | Family Medicine | 400 E 3rd St, Duluth, MN 55805-1951 | 2006-07-19 |
| 1841228301 | Douglas Frederick Hoffman | Family Medicine | 400 E 3rd St, Duluth, MN 55805-1951 | 2006-06-30 |
| 1972539955 | Daniel Lee Mark | Family Medicine | 400 E 3rd St, Duluth, MN 55805-1951 | 2006-06-23 |
| 1497790547 | Wade Alan Lillegard | Family Medicine | 400 E 3rd St, Duluth, MN 55805-1951 | 2006-06-20 |
| 1730124678 | Ann Caroline Sudoh | Family Medicine | 400 E 3rd St, Duluth, MN 55805-1951 | 2006-06-17 |
| 1588610992 | Janus Butcher | Family Medicine | 400 E 3rd St, Duluth, MN 55805-1951 | 2006-05-26 |
| Find all providers in DULUTH | ||||
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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.