MARK CONRAD GREGERSON (NPI# 1508809930) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508809930 |
| Entity Type | Individual |
| Full Name | MARK CONRAD GREGERSON |
| Credential | MD |
| Practice Address |
4572 County Road 61 Moose Lake MN 55767-9401 |
| Practice Telephone | 2184854481 |
| Mailing Telephone | 2184854481 |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2019-11-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | 29943 | MN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 441280000 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1805 Hennepin Ave N, Glencoe, MN 553361416 | 3208643121 |
| Street Address |
4572 COUNTY ROAD 61 |
| City | MOOSE LAKE |
| State | MN |
| Zip Code | 55767-9401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609494657 | Nicholas T Allard | Physical Therapist | 4572 County Road 61, Moose Lake, MN 55767-9401 | 2020-07-07 |
| 1295353258 | Jennifer S Gangelhoff | Occupational Therapist | 4572 County Road 61, Moose Lake, MN 55767-9401 | 2020-07-07 |
| 1164040176 | Ashley I Omar | Occupational Therapist | 4572 County Road 61, Moose Lake, MN 55767-9401 | 2020-07-07 |
| 1134747140 | Claire L Rosen | Occupational Therapist | 4572 County Road 61, Moose Lake, MN 55767-9401 | 2020-07-07 |
| 1750909735 | Keri A Halverson | Speech-Language Pathologist | 4572 County Road 61, Moose Lake, MN 55767-9401 | 2020-07-07 |
| 1629696620 | Magdalena K Hoelmer | Physical Therapist | 4572 County Road 61, Moose Lake, MN 55767-9401 | 2020-07-07 |
| 1932738218 | Essentia Health Moose Lake | Medicare Defined Swing Bed Unit | 4572 County Road 61, Moose Lake, MN 55767-9401 | 2020-04-07 |
| 1154959880 | Essentia Health Moose Lake | General Acute Care Hospital | 4572 County Road 61, Moose Lake, MN 55767-9401 | 2020-03-30 |
| 1245758234 | James Alan Mach Jr. | Nurse Anesthetist, Certified Registered | 4572 County Road 61, Moose Lake, MN 55767-9401 | 2017-08-30 |
| 1023551108 | Samantha Goude | Physical Therapist | 4572 County Road 61, Moose Lake, MN 55767-9401 | 2016-11-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437778529 | Essentia Health Moose Lake | Home Health | 30 Arrowhead Ln, Moose Lake, MN 55767 | 2020-04-09 |
| 1841775475 | Katherine Mcdowell | Social Worker | 451 Arrowhead Lane, Moose Lake, MN 55767 | 2018-09-28 |
| 1316191786 | Vision Pro | Optometrist | 125 W Arrowhead Rd, Moose Lake, MN 55767 | 2008-11-11 |
| 1265627327 | Dr. Joseph J. Jamros Optometry, Ltd. | Optometrist | 312 Elm Ave., Moose Lake, MN 55767 | 2007-09-12 |
| 1013108075 | Diane Louise Stellrecht | Psychologist | 505 3rd Street, Suite A, Moose Lake, MN 55767 | 2007-08-06 |
| 1073674529 | Downtown Dental Care Pa | Dentist | 304 Elm Ave, Moose Lake, MN 55767 | 2006-12-12 |
| 1760558399 | Joseph John Jamros | Optometrist | 312 Elm Ave, Moose Lake, MN 55767 | 2006-11-27 |
| 1205909991 | Msocs-moose Lake | Intermediate Care Facility, Mentally Retarded | 305 4th St, Moose Lake, MN 55767 | 2006-11-17 |
| 1295804482 | Moose Lake Community Hospital District | Home Health | 30 Arrowhead Lane, Moose Lake, MN 55767 | 2006-11-06 |
| 1396770772 | Sonja M. Roach | Nurse Practitioner | 4570 County Highway 61, Moose Lake, MN 55767 | 2006-07-12 |
| Find all providers in zip 55767 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053955385 | Summit Orthopedics Ltd | Orthopaedic Surgery | 4360 12th Ave E, Shakopee, MN 55379-1955 | 2019-10-30 |
| 1639631526 | Multiple Care of Mn, LLC | Orthopaedic Surgery | 8500 Normandale Lake Blvd Ste 350, Bloomington, MN 55437-3805 | 2019-04-01 |
| 1073933719 | Nicholas Adam Lesmeister | Orthopaedic Surgery | 2014 South 6th Street, Brainerd, MN 56401 | 2014-04-21 |
| 1477971174 | Thomas Jay Kaiser | Orthopaedic Surgery | 35 State Ave Ste 1, Faribault, MN 55021-6369 | 2014-03-31 |
| 1073876876 | Daniel Borgen | Orthopaedic Surgery | 1811 Pennsylvania Ave N, Golden Valley, MN 55427-4015 | 2012-06-18 |
| 1194019729 | John Allen Wilson Jr. | Orthopaedic Surgery | 7327 Rogers Point Rd Nw, Walker, MN 56484-2523 | 2011-05-31 |
| 1952693749 | Kurt Joseph Duncan | Orthopaedic Surgery | 8650 Hudson Blvd N Ste 100, Lake Elmo, MN 55042-8416 | 2011-05-11 |
| 1407155054 | Paul T. Wicklund, M.d., P.a. | Orthopaedic Surgery | 6545 France Ave S Ste 363, Edina, MN 55435-2121 | 2011-03-22 |
| 1861712861 | Wayne William Thompson | Orthopaedic Surgery | 1651 Saunders Ave, Saint Paul, MN 55116-2430 | 2010-06-02 |
| 1124357512 | William Jarvis Busby | Orthopaedic Surgery | 501 Holly Cir, Wayzata, MN 55391-1369 | 2009-12-14 |
| Find all providers with the same taxonomy | ||||
| City | MOOSE LAKE |
| Zip Code | 55767 |
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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.